Provider Demographics
NPI:1922169150
Name:D'AUNOY, MARY ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:D'AUNOY
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 1:47 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4672
Mailing Address - Country:US
Mailing Address - Phone:863-291-5110
Mailing Address - Fax:
Practice Address - Street 1:601 S FLORIDA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5237
Practice Address - Country:US
Practice Address - Phone:863-688-0841
Practice Address - Fax:863-616-9709
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123469208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015572400Medicaid
FL015572400Medicaid