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General NPI Number Information
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NPI Number | 1366804858
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Entity Type | Individual
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Provider Name | MATTHEW BRIAN DONOVAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 3280 N MCMULLEN BOOTH RD STE 120
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City | CLEARWATER
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State | FL
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Zip | 33761-2046
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Country | US
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Telephone | 727-862-3090
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Fax | 727-862-3023
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Provider Business Mailing Address
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Address Line | 6333 N FEDERAL HWY STE 300
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-1909
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Country | US
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Telephone | 954-776-6880
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Fax | 954-229-3100
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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 | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | ME145329
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME145329
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License Number State | FL
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