Provider Demographics
NPI:1447529375
Name:WHITLEY, DONOVAN GLENN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:GLENN
Last Name:WHITLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 SW 34TH ST
Mailing Address - Street 2:APT #325
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8417
Mailing Address - Country:US
Mailing Address - Phone:386-365-2210
Mailing Address - Fax:
Practice Address - Street 1:7921 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-3976
Practice Address - Country:US
Practice Address - Phone:352-854-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist