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NPI Code Detail

MEDICARE: DR. DANIEL J DONOFRIO MD

MEDICARE:  DR. DANIEL J DONOFRIO  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
1207Q00000XFamily Medicine PhysicianPA2674FL
2207Q00000XFamily Medicine Physician002785GA
3207Q00000XFamily Medicine PhysicianME106486FL

Other Identifiers

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

General Provider Information

NPI Number : 1710090915
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL J DONOFRIO MD
Provider Business Mailing Address
First Line : 130 HEALTH PARK BLVD
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-5776
Country : US
Telephone Number : 904-826-3469
Fax Number : 904-808-4608
Provider Business Practice Location Address
First Line : 130 HEALTH PARK BLVD
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-5776
Country : US
Telephone Number : 904-826-3469
Fax Number : 904-808-4608
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 09/11/2024

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Directions to “ DR. DANIEL J DONOFRIO MD” Practice Location

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