Provider Demographics
NPI:1639184351
Name:NEMBHARD, DONOVAN F (MD)
Entity Type:Individual
Prefix:
First Name:DONOVAN
Middle Name:F
Last Name:NEMBHARD
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 1:1899 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1401
Mailing Address - Country:US
Mailing Address - Phone:954-725-7291
Mailing Address - Fax:954-708-2553
Practice Address - Street 1:1899 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1401
Practice Address - Country:US
Practice Address - Phone:954-725-7291
Practice Address - Fax:954-708-2553
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274910600Medicaid
FLU55082Medicare ID - Type Unspecified
FL274910600Medicaid
FLF20389Medicare UPIN