Provider Demographics
NPI:1659863603
Name:DONALDSON, SHAMAR
Entity Type:Individual
Prefix:
First Name:SHAMAR
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 TORRES CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8118
Mailing Address - Country:US
Mailing Address - Phone:561-614-7279
Mailing Address - Fax:
Practice Address - Street 1:425 EXECUTIVE CENTER DR APT 203
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2954
Practice Address - Country:US
Practice Address - Phone:786-683-2638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health