Jacqueline Samantha Demarco, PHARM.D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PS57580 Issued in FL

Practice address

11140 Lynwood Palm Way
Palm Beach Gardens, FL 33412-2470

Phone

(631) 300-6320

Fax

(954) 208-0066

NPI assigned

Mar 24, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optimal Health & Wellness LLC

  • Health Service Clinic/Center
  • Palm Beach Gardens, FL
  • NPI 1962160622
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1609190305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MONTROSE DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251313",
            "telephone_number": "631-300-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 LYNWOOD PALM WAY",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334122470",
            "telephone_number": "631-300-6320",
            "fax_number": "954-208-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "JACQUELINE",
        "middle_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "FL",
            "license": "PS57580",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "054059",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS57580",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054059",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS57580",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "NY",
            "license": "054059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Jackie@functionalmedicineconsultants.com",
            "affiliation": "N",
            "address_1": "11140 Lynwood Palm Way",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334122470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Crawford Dell
• Joann Dellutri
• Albertino E Delossantos
• Jessica Nicole Delrossi
• Melissa Delsesto, M.S., CCC-SLP
• Delia Demchak
• Denise Lederman LCSW, LNC, PA
• Hannah Joann Denkler
• Jessica Denson
• Dental Asset Management (Palm Beach Dental Group)

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.