Provider Demographics
NPI:1902861503
Name:RHODEN, DONNA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:KAY
Last Name:RHODEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5458 TOWN CENTER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1089
Mailing Address - Country:US
Mailing Address - Phone:561-750-9596
Mailing Address - Fax:
Practice Address - Street 1:5458 TOWN CENTER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1089
Practice Address - Country:US
Practice Address - Phone:561-750-9596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME702262080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379568300Medicaid
FLE85905Medicare UPIN