Michelle R Demenkow, PA

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ARNP9211884 Issued in FL

Legal business name

MICHELLE R DEMENKOW, PA

Practice address

14201 W Sunrise Blvd Ste 208
Sunrise, FL 33323

Phone

(954) 851-9690

Fax

(954) 366-5056

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michelle R Demenkow, PH.D.NPI 1063606614

Title

Owner

Phone

(954) 856-8703

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Networks

• HealthSun Health Plans Network

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Rene Demenkow, PH.D.

  • Psychiatric/Mental Health Nurse Practitioner
  • Sunrise, FL
  • NPI 1063606614

  FL

  Medicare reassignment Authorized official
• Ana Lila Abello, PSY.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1093746521

  Clinical

  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1962435271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD STE 208",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-851-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD STE 208",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "33323",
            "telephone_number": "954-851-9690",
            "fax_number": "954-366-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE R DEMENKOW, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "DEMENKOW",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-856-8703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6763",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9211884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reim Michael, CCC-SLP
• Baltany Michel, OTR/L
• Leonardo Michelena Felipe, RBT
• Ana Maria Michelena, MD
• Melissa Michelin, LMFT
• Gourav Miglani
• Millennium Anesthesia PA
• Barbara Yvonne Miller
• Ialeah Ashantia Miller
• Janine Miller, PHARM D.

• All providers in Sunrise, FL
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.