Healthcare Provider Details

I. General information

NPI: 1760400030
Provider Name (Legal Business Name): ROBERT B DONOWAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 HOLLYWOOD BLVD PRESIDENTIAL CIRCLE, SUITE 160 NORTH
HOLLYWOOD FL
33021-6751
US

IV. Provider business mailing address

2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 954-986-6366
  • Fax: 954-986-4355
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME0058579
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME58579
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: