Provider Demographics
NPI:1194841122
Name:HOARAU, DWIGHT DWAIN (MD)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:DWAIN
Last Name:HOARAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1055 SAXON BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8468
Mailing Address - Country:US
Mailing Address - Phone:386-917-5526
Mailing Address - Fax:386-917-5553
Practice Address - Street 1:1055 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8468
Practice Address - Country:US
Practice Address - Phone:386-917-5526
Practice Address - Fax:386-917-5553
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012359952085R0202X
FLME983522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology