Provider Demographics
NPI:1346489937
Name:DAKE, VYAS NARESH (MD)
Entity Type:Individual
Prefix:DR
First Name:VYAS
Middle Name:NARESH
Last Name:DAKE
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 1:8727 TEMPLE TERRACE HWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-6700
Mailing Address - Country:US
Mailing Address - Phone:813-796-5400
Mailing Address - Fax:813-776-0079
Practice Address - Street 1:8727 TEMPLE TERRACE HWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-6700
Practice Address - Country:US
Practice Address - Phone:813-796-5400
Practice Address - Fax:813-776-0079
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10031137207Q00000X
NMMD2011-0207207Q00000X
FLME152591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ2565OtherMEDICAID GROUP
NM1932187044OtherGROUP NPI
NM85001732Medicaid
NM800521089OtherMEDICARE GROUP ID
NM85001732Medicaid