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General NPI Number Information
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NPI Number | 1487096632
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Entity Type | Individual
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Provider Name | MICHAEL V DIDONNA DO
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Gender | Male
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1730 S PINELLAS AVE STE J
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1953
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Country | US
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Telephone | 727-888-3043
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Fax | 727-940-8047
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Provider Business Mailing Address
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Address Line | 1730 S PINELLAS AVE STE J
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-1953
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Country | US
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Telephone | 727-888-3043
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Fax | 727-940-8047
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS12855
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License Number State | FL
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