MEDICARE: DR. GUILLERMO A. DONATE D.P.M.

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	213ES0000X	Sports Medicine Podiatrist	PO2970	FL
2	213ES0131X	Foot Surgery Podiatrist	PO2970	FL
3	213ES0103X	Foot & Ankle Surgery Podiatrist	PO2970	FL
4	213E00000X	Podiatrist	PO2970	FL
5	213EP1101X	Primary Podiatric Medicine Podiatrist	PO2970	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	:	1891800066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUILLERMO A. DONATE D.P.M.

Provider Business Mailing Address
First Line	:	16350 BRUCE B DOWNS BLVD UNIT 46879
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3207
Country	:	US
Telephone Number	:	813-994-0213
Fax Number	:	813-994-0105

Provider Business Practice Location Address
First Line	:	16350 BRUCE B DOWNS BLVD UNIT 46879
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3207
Country	:	US
Telephone Number	:	813-994-0213
Fax Number	:	813-994-0105

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	06/27/2024

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Directions to “ DR. GUILLERMO A. DONATE D.P.M.” Practice Location

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