=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558907337
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONNA M RHODES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2019
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4500 BELVEDERE RD STE D
-----------------------------------------------------
City | HAVERHILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33415-1357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-576-1861
-----------------------------------------------------
Fax | 866-422-7259
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 229 GAZETTA WAY
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33413-1051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 754-422-2397
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 11004790
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------