# MICHELLE R DEMENKOW, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962435271
- **Authorized official:** DR. MICHELLE R DEMENKOW PH.D. (OWNER)
- **Authorized official phone:** (954) 856-8703

## Contact information

- **Practice address:** 14201 W SUNRISE BLVD STE 208, SUNRISE, FL 33323
- **Practice address phone:** (954) 851-9690
- **Practice address fax:** (954) 366-5056
- **Mailing address:** 14201 W SUNRISE BLVD STE 208, SUNRISE, FL 33323-3207
- **Mailing address phone:** (954) 851-9690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | PY6763 | FL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | ARNP9211884 | FL | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 05/20/2020