Provider Demographics
NPI:1871589028
Name:DONAHUE, DAVID M (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:DONAHUE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1790 E VENICE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-3191
Mailing Address - Country:US
Mailing Address - Phone:941-488-8884
Mailing Address - Fax:941-488-5554
Practice Address - Street 1:1790 E VENICE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3191
Practice Address - Country:US
Practice Address - Phone:941-488-8884
Practice Address - Fax:941-488-5554
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-09-22
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Provider Licenses
StateLicense IDTaxonomies
FLOS81752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7740210OtherAETNA
FLP00068868OtherRAILROAD MEDICARE
FL258932-000OtherMAGELLAN
FL760461100Medicaid
FL2056243OtherCIGNA
FL35964OtherBCBS FLORIDA
FL7341763OtherGHI-VALUEOPTIONS
FL258932-000OtherMAGELLAN
FL35964OtherBCBS FLORIDA