Individual
DR. GLADYS VANESSA MATTA DEMOCKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 UNIVERSITY PKWY STE 219, SARASOTA, FL 34243-2809
(800) 687-1938
Mailing address
6025 FERNDELL ST, BRADENTON, FL 34203-7325
(941) 224-7213
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY7298
FL
Other
Enumeration date
06/03/2021
Last updated
06/11/2021
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