Provider Demographics
NPI:1881134567
Name:VAICIUNAITE, DONATA (DO)
Entity type:Individual
Prefix:
First Name:DONATA
Middle Name:
Last Name:VAICIUNAITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1419 SE 8TH TER STE 200
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3213
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:21 BARKLEY CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7531
Practice Address - Country:US
Practice Address - Phone:239-939-2616
Practice Address - Fax:239-939-9093
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS021908208600000X
FLOS20401208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
15589404OtherCAQH