Provider Demographics
NPI:1568418648
Name:TAYLOR, DONOVAN DUHANEY (MD)
Entity Type:Individual
Prefix:
First Name:DONOVAN
Middle Name:DUHANEY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 NW 114TH AVE
Mailing Address - Street 2:UNIT 1P PTY14575
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33192-4462
Mailing Address - Country:US
Mailing Address - Phone:954-270-4806
Mailing Address - Fax:
Practice Address - Street 1:3490 FOXCROFT RD APT 210
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4157
Practice Address - Country:US
Practice Address - Phone:954-434-4528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005783OtherNEIGHBORHOOD HEALTH PLAN
FL31437OtherBLUE CROSS & BLUE SHIELD
FL216940OtherAVMED
FL216940OtherAVMED
FLG32474Medicare UPIN