Provider Demographics
NPI:1053651000
Name:DASVARMA, RANENDRA (MD)
Entity Type:Individual
Prefix:
First Name:RANENDRA
Middle Name:
Last Name:DASVARMA
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 1:2171 PINE RIDGE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2002
Mailing Address - Country:US
Mailing Address - Phone:239-566-7425
Mailing Address - Fax:239-593-3430
Practice Address - Street 1:2171 PINE RIDGE RD
Practice Address - Street 2:SUITE F
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2002
Practice Address - Country:US
Practice Address - Phone:239-566-7425
Practice Address - Fax:239-593-3430
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine