MEDICARE: DAVARIUS BARGNARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TR0400X	Rehabilitation Psychologist

General Provider Information

NPI Number	:	1699494989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVARIUS BARGNARE

Provider Business Mailing Address
First Line	:	1762 MORNING SKY DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5339
Country	:	US
Telephone Number	:	407-953-8560
Fax Number	:

Provider Business Practice Location Address
First Line	:	7041 GRAND NATIONAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-8381
Country	:	US
Telephone Number	:	407-982-7718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “ DAVARIUS BARGNARE ” Practice Location

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