Provider Demographics
NPI:1588297899
Name:DWARKA, RICHARD CHRISTOPHE
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHRISTOPHE
Last Name:DWARKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 DELAWARE RD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2914
Mailing Address - Country:US
Mailing Address - Phone:347-355-2940
Mailing Address - Fax:
Practice Address - Street 1:2685 DELAWARE RD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2914
Practice Address - Country:US
Practice Address - Phone:347-355-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL20000043924343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)