Provider Demographics
NPI:1730585753
Name:DEMEZIER, BARTHELEMY JOSNEL
Entity type:Individual
Prefix:
First Name:BARTHELEMY
Middle Name:JOSNEL
Last Name:DEMEZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 RUTHERFORD DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:FL
Mailing Address - Zip Code:33527-4933
Mailing Address - Country:US
Mailing Address - Phone:561-715-4182
Mailing Address - Fax:
Practice Address - Street 1:2014 RUTHERFORD DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:FL
Practice Address - Zip Code:33527-4933
Practice Address - Country:US
Practice Address - Phone:561-715-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL805-028-776Medicaid
FL802-035-767Medicaid