Healthcare Provider Details

I. General information

NPI: 1770246985
Provider Name (Legal Business Name): DONNELLE MCDONALD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S JOG RD STE 100
DELRAY BEACH FL
33446-3808
US

IV. Provider business mailing address

670 CHRISTINA DR APT 201
ROYAL PALM BEACH FL
33414-2205
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-5144
  • Fax: 561-496-5201
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPT37593
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT37593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: