Provider Demographics
NPI:1861713018
Name:DHIRAJ WARMAN MD PA
Entity type:Organization
Organization Name:DHIRAJ WARMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DHIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:WARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:352-683-3136
Mailing Address - Street 1:PO BOX 340609
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33694-0609
Mailing Address - Country:US
Mailing Address - Phone:352-683-3136
Mailing Address - Fax:352-683-3160
Practice Address - Street 1:10441 QUALITY DR STE 300
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9650
Practice Address - Country:US
Practice Address - Phone:352-683-3136
Practice Address - Fax:352-683-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN143941223G0001X
FLME68576207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN14394OtherDENTIST
FL260742500Medicaid
FLME68576OtherMEDICAL LICENSE
FLDN14394OtherDENTIST
FL51637Medicare PIN