Provider Information for 1275116436
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DEMETRIUS JIFUNZA LMHC
Sex: Male
Certification Date: 2024-02-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1275116436 | ||||||||
| Enumeration Date | 2021-05-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1000 DEPT. #394 MEMPHIS, TN 34148 United States Phone: 941-300-4440 | Fax:941-404-1760 | ||||||||
| Primary Practice Address | 14243 TAMIAMI TRL NORTH PORT, FL 34287-2215 United States Phone: 941-888-2144 | Fax:888-213-0604 | ||||||||
| Secondary Practice Address(es) | 1224 DEL PRADO BLVD S STE A 1301 W COLONIAL DR STE A 1231 N TUTTLE AVE 3251 3RD AVE N RM 125 14243 TAMIAMI TRL 2349 SUNSET POINT RD STE 405 1435 DUNN AVE STE 101 1825 HURLBURT RD STE 14 4615 PHILIPS HWY STE 3 201 N DIXIE HWY 18360 NW 47TH AVE 4758 ROWAN RD 408 7TH ST W 8390 N PALAFOX ST 4101 NW 3RD CT STE 9 427 WASHINGTON AVE 2105 N NEBRASKA AVE | ||||||||
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