Healthcare Provider Details

I. General information

NPI: 1780794206
Provider Name (Legal Business Name): JEFFREY M. DONOHOE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 HAGEN RANCH RD
BOYNTON BEACH FL
33437-3724
US

IV. Provider business mailing address

10301 HAGEN RANCH RD
BOYNTON BEACH FL
33437-3724
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-7313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number056280
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number056280
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number56280
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberME143435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: