Provider Demographics
NPI:1649528407
Name:DWARES, CURTIS (FNP)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:
Last Name:DWARES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32641-7516
Mailing Address - Country:US
Mailing Address - Phone:352-334-7900
Mailing Address - Fax:352-334-8897
Practice Address - Street 1:224 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-7516
Practice Address - Country:US
Practice Address - Phone:352-334-7900
Practice Address - Fax:352-334-8897
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2513262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008556100Medicaid
FLHD426ZMedicare PIN