MEDICARE: ROBERT DONNELLY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME0076495	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053304022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT DONNELLY MD

Provider Business Mailing Address
First Line	:	1660 GULF TO BAY BLVD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-6423
Country	:	US
Telephone Number	:	727-446-5633
Fax Number	:	727-447-6312

Provider Business Practice Location Address
First Line	:	1660 GULF TO BAY BLVD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755
Country	:	US
Telephone Number	:	727-446-5633
Fax Number	:	727-447-6312

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	08/25/2015

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Directions to “ ROBERT DONNELLY MD” Practice Location

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