Provider Demographics
NPI:1043201130
Name:MCDONALD, DONNA A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:A
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1111 CRANDON BLVD
Mailing Address - Street 2:C1105
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-2745
Mailing Address - Country:US
Mailing Address - Phone:305-361-9467
Mailing Address - Fax:305-361-7401
Practice Address - Street 1:2000 S DIXIE HWY
Practice Address - Street 2:103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2456
Practice Address - Country:US
Practice Address - Phone:305-670-6011
Practice Address - Fax:305-361-7401
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY0004842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59405Medicare ID - Type Unspecified