Healthcare Provider Details

I. General information

NPI: 1821066309
Provider Name (Legal Business Name): JASON JOSEPH DONAY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AVENUE F NE STE 9118
WINTER HAVEN FL
33881-4131
US

IV. Provider business mailing address

200 AVENUE F NE STE 9118
WINTER HAVEN FL
33881-4131
US

V. Phone/Fax

Practice location:
  • Phone: 863-297-1777
  • Fax: 863-297-1756
Mailing address:
  • Phone: 863-292-4004
  • Fax: 863-292-4005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA103019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: