Provider Demographics
NPI:1891800066
Name:DONATE, GUILLERMO A (DPM)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:A
Last Name:DONATE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 WINDGUARD CIR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7354
Mailing Address - Country:US
Mailing Address - Phone:813-994-0213
Mailing Address - Fax:813-994-0105
Practice Address - Street 1:2621 WINDGUARD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7354
Practice Address - Country:US
Practice Address - Phone:813-994-0213
Practice Address - Fax:813-994-0105
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2970213E00000X, 213EP1101X, 213ES0000X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006495800Medicaid
FL006495800Medicaid