Provider Demographics
NPI:1699494989
Name:BARGNARE, DAVARIUS
Entity type:Individual
Prefix:
First Name:DAVARIUS
Middle Name:
Last Name:BARGNARE
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 1:1762 MORNING SKY DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5339
Mailing Address - Country:US
Mailing Address - Phone:407-953-8560
Mailing Address - Fax:
Practice Address - Street 1:7041 GRAND NATIONAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8381
Practice Address - Country:US
Practice Address - Phone:407-982-7718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation