Healthcare Provider Details

I. General information

NPI: 1356135339
Provider Name (Legal Business Name): GRACE DONNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 103450
GAINESVILLE FL
32610-3450
US

IV. Provider business mailing address

PO BOX 103450
GAINESVILLE FL
32610-3450
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: