Healthcare Provider Details

I. General information

NPI: 1164351466
Provider Name (Legal Business Name): DANICA LAVARIAS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 40TH ST STE 170
BALTIMORE MD
21211-2147
US

IV. Provider business mailing address

1609 RIVERWOOD CIR
JOPPA MD
21085-5442
US

V. Phone/Fax

Practice location:
  • Phone: 667-600-4560
  • Fax:
Mailing address:
  • Phone: 443-653-6151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30829
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: