Healthcare Provider Details

I. General information

NPI: 1760786008
Provider Name (Legal Business Name): DONNELLY FAMILY PRACTITIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2010
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MILITARY TRL SUITE 245
BOCA RATON FL
33431-6365
US

IV. Provider business mailing address

42 SW 5TH WAY
BOCA RATON FL
33432-4731
US

V. Phone/Fax

Practice location:
  • Phone: 561-994-2007
  • Fax: 561-994-2003
Mailing address:
  • Phone: 561-213-0763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANNE B DONNELLY
Title or Position: OWNER
Credential: ARNP
Phone: 561-213-0763