Provider Demographics
NPI:1659362770
Name:DONKIN, VICTORIA L (OD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:DONKIN
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 1:160 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4798
Mailing Address - Country:US
Mailing Address - Phone:407-834-7776
Mailing Address - Fax:407-834-0973
Practice Address - Street 1:5727 CANTON CV
Practice Address - Street 2:SUITE 111
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5033
Practice Address - Country:US
Practice Address - Phone:407-834-7776
Practice Address - Fax:407-834-0973
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2322152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620267500Medicaid
FL19585UMedicare PIN
FL19585RMedicare PIN
FL620267500Medicaid
FLU34015Medicare UPIN
FL19585JMedicare PIN
FL19585NMedicare PIN
FL19585PMedicare PIN
FL19585MMedicare PIN