Provider Demographics
NPI:1629127717
Name:DONOHUE, ESPERANZA VILLAMAYOR (RNFA)
Entity Type:Individual
Prefix:
First Name:ESPERANZA
Middle Name:VILLAMAYOR
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13264 60TH ST N
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8371
Mailing Address - Country:US
Mailing Address - Phone:561-790-4769
Mailing Address - Fax:772-335-2422
Practice Address - Street 1:13264 60TH ST N
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8371
Practice Address - Country:US
Practice Address - Phone:561-790-4769
Practice Address - Fax:772-335-2422
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2244002163WM0705X, 163WX0003X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY1294OtherBCBS PROVIDER NUMBER