Provider Demographics
NPI:1396725107
Name:DWYER, DANIEL HARRY (RN)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:HARRY
Last Name:DWYER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:H
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7954 SE MAMMOTH DR
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7896
Mailing Address - Country:US
Mailing Address - Phone:561-422-6957
Mailing Address - Fax:561-422-7615
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-6957
Practice Address - Fax:561-422-7615
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1811282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse