Provider Demographics
NPI:1669437786
Name:CENTNER, DONALD J (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:CENTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1432
Mailing Address - Country:US
Mailing Address - Phone:407-893-8200
Mailing Address - Fax:407-893-8220
Practice Address - Street 1:1911 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-893-8200
Practice Address - Fax:407-893-8220
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82458207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29509OtherBCBS
FL7345681OtherAETNA HMO
FL253428200Medicaid
FL7345681OtherAETNA PPO/POS
FL2714942OtherUNITED HEALTH CARE
FL9595040OtherCIGNA
FL$$$$$$$$$OtherTRI CARE
FL7345681OtherAETNA HMO
FLP00338534Medicare PIN