Provider Demographics
NPI:1295013035
Name:MORITZ, DONNA COHEN (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:COHEN
Last Name:MORITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:C
Other - Last Name:MORITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13455 S MILITARY TRL STE A
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1323
Mailing Address - Country:US
Mailing Address - Phone:561-288-6153
Mailing Address - Fax:561-288-6087
Practice Address - Street 1:13455 S MILITARY TRL STE A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-1323
Practice Address - Country:US
Practice Address - Phone:561-288-6153
Practice Address - Fax:561-288-6087
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145076207RI0200X
IL036140731207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036140731001Medicaid