Provider Demographics
NPI:1992795660
Name:DHARIA, NARENDRA M (MD)
Entity type:Individual
Prefix:
First Name:NARENDRA
Middle Name:M
Last Name:DHARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1394
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-1394
Mailing Address - Country:US
Mailing Address - Phone:407-909-1889
Mailing Address - Fax:407-909-1891
Practice Address - Street 1:1825 N MILLS AVE
Practice Address - Street 2:LAKESIDE SURGERY CENTER
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1853
Practice Address - Country:US
Practice Address - Phone:407-206-2375
Practice Address - Fax:407-206-2377
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045024207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47742Medicare ID - Type Unspecified