Provider Demographics
NPI:1811223274
Name:BHARADWA, DAPHNIE VANESSA (ARNP)
Entity Type:Individual
Prefix:DR
First Name:DAPHNIE
Middle Name:VANESSA
Last Name:BHARADWA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:DR
Other - First Name:DAPHNIE
Other - Middle Name:VANESSA
Other - Last Name:PEREZ-CASTRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:6701 HIATUS RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6406
Mailing Address - Country:US
Mailing Address - Phone:954-718-3256
Mailing Address - Fax:
Practice Address - Street 1:6701 HIATUS RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6406
Practice Address - Country:US
Practice Address - Phone:954-718-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9178753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily