Provider Demographics
NPI:1164548889
Name:JON D DONSHIK MD PA
Entity Type:Organization
Organization Name:JON D DONSHIK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:D
Authorized Official - Last Name:DONSHIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-888-1000
Mailing Address - Street 1:301 NW 84TH AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1807
Mailing Address - Country:US
Mailing Address - Phone:954-888-1000
Mailing Address - Fax:954-888-1446
Practice Address - Street 1:301 NW 84TH AVE STE 303
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1807
Practice Address - Country:US
Practice Address - Phone:954-888-1000
Practice Address - Fax:954-888-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79363207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty