Provider Demographics
NPI:1083680300
Name:DARIO, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:DARIO
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 1:10051 5TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2289
Mailing Address - Country:US
Mailing Address - Phone:727-869-7755
Mailing Address - Fax:727-869-7372
Practice Address - Street 1:10435 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-3133
Practice Address - Country:US
Practice Address - Phone:727-869-7755
Practice Address - Fax:727-869-7372
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271734400Medicaid
FL271734400Medicaid
FL26351ZMedicare PIN