Provider Demographics
NPI:1326134883
Name:DORR, DONALD SCHAFER (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:SCHAFER
Last Name:DORR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 MANGO AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-2024
Mailing Address - Country:US
Mailing Address - Phone:727-345-3480
Mailing Address - Fax:
Practice Address - Street 1:3210 DR MARTIN LUTHER KING JR ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1202
Practice Address - Country:US
Practice Address - Phone:727-894-2020
Practice Address - Fax:727-894-2020
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC001528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19822Medicare ID - Type Unspecified
FLT85243Medicare UPIN