Provider Demographics
NPI:1255336053
Name:JAMIESON, DONNA M (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:JAMIESON
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 1:2650 BAHIA VISTA ST
Mailing Address - Street 2:STE 304
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2634
Mailing Address - Country:US
Mailing Address - Phone:941-366-9711
Mailing Address - Fax:941-957-0079
Practice Address - Street 1:2650 BAHIA VISTA ST
Practice Address - Street 2:STE 304
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2634
Practice Address - Country:US
Practice Address - Phone:941-366-9711
Practice Address - Fax:941-957-0079
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46453207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56986Medicare UPIN
FL58475Medicare ID - Type Unspecified