MEDICARE: GARY R DONSHIK M.D.

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	207RC0000X	Cardiovascular Disease Physician	ME17852	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

General Provider Information

NPI Number	:	1538162466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY R DONSHIK M.D.

Provider Business Mailing Address
First Line	:	3335 N UNIVERSITY DR
Second Line	:	SUITE 8
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2200
Country	:	US
Telephone Number	:	954-965-4900
Fax Number	:	954-515-1236

Provider Business Practice Location Address
First Line	:	21097 NE 27TH CT
Second Line	:	SUITE 320
City	:	AVENTURA
State	:	FL
Zip	:	33180-1204
Country	:	US
Telephone Number	:	305-933-8465
Fax Number	:	305-933-0797

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/20/2008

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Directions to “ GARY R DONSHIK M.D.” Practice Location

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