Provider Demographics
NPI:1588388052
Name:DORVILUS, DACHENA BARTHELUS (CNA)
Entity type:Individual
Prefix:
First Name:DACHENA
Middle Name:BARTHELUS
Last Name:DORVILUS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:DACHENA
Other - Middle Name:
Other - Last Name:BARTHELUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:390 WOODBINE WAY APT 303
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6543
Mailing Address - Country:US
Mailing Address - Phone:561-581-6910
Mailing Address - Fax:
Practice Address - Street 1:390 WOODBINE WAY APT 303
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-6543
Practice Address - Country:US
Practice Address - Phone:561-581-6910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA255429251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health