Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME00053576 | FL |
NPI | 1831109404 |
---|---|
Provider Name | John Drummond Donaldson |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-5769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040003216 | RAILROAD MEDICARE (01) | |
0496121 | AETNA (01) | |
062747000 | (05) | FL |
10132 | BCBS (01) | |
1200136002 | CIGNA (01) | |
15738 | WELLCARE (01) | |
205269 | AMERIGROUP (01) | |
268721600 | GROUP MEDICAID (01) | FL |
591315597 | TAX ID (01) | FL |
E75891 | (02) |