Provider Demographics
NPI:1255754495
Name:DONER, KATHY SUE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:SUE
Last Name:DONER
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 1:6945 CREPE MYRTLE DR
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:FL
Mailing Address - Zip Code:32949-5300
Mailing Address - Country:US
Mailing Address - Phone:321-725-3691
Mailing Address - Fax:
Practice Address - Street 1:6945 CREPE MYRTLE DR
Practice Address - Street 2:
Practice Address - City:GRANT
Practice Address - State:FL
Practice Address - Zip Code:32949-5300
Practice Address - Country:US
Practice Address - Phone:321-725-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine