Provider Demographics
NPI:1487203428
Name:DONMAR HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:DONMAR HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RN
Authorized Official - Prefix:
Authorized Official - First Name:MARIE ERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-264-3396
Mailing Address - Street 1:5849 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1347
Mailing Address - Country:US
Mailing Address - Phone:561-264-3396
Mailing Address - Fax:561-210-3080
Practice Address - Street 1:5849 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1347
Practice Address - Country:US
Practice Address - Phone:561-264-3396
Practice Address - Fax:561-210-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS9465OtherLICENSE NUMBER