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General NPI Number Information
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NPI Number | 1184878746
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH DONOVAN M.D. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 1400 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1003
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Country | US
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Telephone | 305-243-9149
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 NW 14TH ST
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City | MIAMI
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State | FL
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Zip | 33136-2137
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Country | US
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Telephone | 617-763-7647
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME-145802
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 183863
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 2005-01672
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License Number State | NC
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