Provider Demographics
NPI:1902829443
Name:KING, DONNA LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LEE
Last Name:KING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8816 STANMOORE RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-3024
Mailing Address - Country:US
Mailing Address - Phone:813-986-6629
Mailing Address - Fax:813-986-6629
Practice Address - Street 1:635 EICHENFELD DR
Practice Address - Street 2:BAY AREA CARDIOLOGY
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5908
Practice Address - Country:US
Practice Address - Phone:813-684-6000
Practice Address - Fax:813-654-9032
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP485532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255799300Medicaid
FL89852Medicare UPIN
FLE3109Medicare ID - Type UnspecifiedARNP