Healthcare Provider Details

I. General information

NPI: 1487027637
Provider Name (Legal Business Name): DONOFFA ELISABETH NELSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 SW HIGHWAY 200 BLDG 90
OCALA FL
34481-9612
US

IV. Provider business mailing address

11916 SW 12TH ST
PEMBROKE PINES FL
33025-3700
US

V. Phone/Fax

Practice location:
  • Phone: 352-671-2320
  • Fax: 352-820-5690
Mailing address:
  • Phone: 788-644-7998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS13504
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS13504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: