Individual provider Active NPI

Frederick Demella Jr., RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Punta Gorda, FL
National Provider Identifier
1730057571
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PS53140 Issued in FL
Practice address
2595 Tarpon Cove Dr Apt 1212
Punta Gorda, FL 33950-1915
Phone
(941) 629-1181
NPI assigned
Oct 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202012795 VA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PCT.0005764 CT
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS53140 FL Primary

Addresses

Primary practice location

2595 Tarpon Cove Dr Apt 1212
Punta Gorda, FL 33950-1915

Mailing address

2595 Tarpon Cove Dr Apt 1212
Punta Gorda, FL 33950-1915
Phone (941) 629-1181

Other names 1

  • Frederick De Mella Jr. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PCT.0005764CTMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PS53140FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
0202012795VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1730057571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 TARPON COVE DR APT 1212",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339501915",
            "telephone_number": "941-629-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 TARPON COVE DR APT 1212",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339501915",
            "telephone_number": "941-629-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELLA",
        "first_name": "FREDERICK",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202012795",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "PCT.0005764",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS53140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FREDERICK",
            "last_name": "DE MELLA",
            "suffix": "JR.",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.