Provider Demographics
NPI:1982876801
Name:DHANIERAM, BARBARA PATRICIA
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:PATRICIA
Last Name:DHANIERAM
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 1:11320 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7041
Mailing Address - Country:US
Mailing Address - Phone:813-383-7162
Mailing Address - Fax:813-383-7162
Practice Address - Street 1:11320 TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7041
Practice Address - Country:US
Practice Address - Phone:813-383-7162
Practice Address - Fax:813-383-7162
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906199172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker