Provider Demographics
NPI:1164614939
Name:DIDONATO, LOUIS RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:RICHARD
Last Name:DIDONATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:DIDONATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6001 N OCEAN DR
Mailing Address - Street 2:APT 1206
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019
Mailing Address - Country:US
Mailing Address - Phone:954-924-2723
Mailing Address - Fax:954-924-9129
Practice Address - Street 1:6001 N OCEAN DR
Practice Address - Street 2:APT 1206
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019
Practice Address - Country:US
Practice Address - Phone:954-924-2723
Practice Address - Fax:954-924-9129
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC86652085R0202X
NM701232085R0202X
NY10345812085R0202X
PAMD010692E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology