Provider Demographics
NPI:1508655424
Name:BARNES, DWANNE LUCINDA
Entity type:Individual
Prefix:MS
First Name:DWANNE
Middle Name:LUCINDA
Last Name:BARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 AZALEA BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567-2108
Mailing Address - Country:US
Mailing Address - Phone:470-543-5165
Mailing Address - Fax:
Practice Address - Street 1:3221 AZALEA BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33567-2108
Practice Address - Country:US
Practice Address - Phone:470-543-5165
Practice Address - Fax:470-543-5165
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL25000214845343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33-4913231OtherTOP FLIGHT CARELLC
FL33-4913231Medicaid