Provider Demographics
NPI:1053930859
Name:DEMARCO, NATALE JR (DO)
Entity type:Individual
Prefix:MR
First Name:NATALE
Middle Name:
Last Name:DEMARCO
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. NAVAL HOSPITAL GUANTANAMO BAY, CUBA
Mailing Address - Street 2:PSC 1005, BOX 11185
Mailing Address - City:GUANTANAMO BAY
Mailing Address - State:CUBA
Mailing Address - Zip Code:FPO AA 34009
Mailing Address - Country:CU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL GUANTANAMO BAY
Practice Address - Street 2:HOSPITAL POINT ROAD
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:34009
Practice Address - Country:US
Practice Address - Phone:757-458-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN02007883A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program