Provider Demographics
NPI:1538162466
Name:DONSHIK, GARY R (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:R
Last Name:DONSHIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3335 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2200
Mailing Address - Country:US
Mailing Address - Phone:954-965-4900
Mailing Address - Fax:954-515-1236
Practice Address - Street 1:21097 NE 27TH CT
Practice Address - Street 2:SUITE 320
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1204
Practice Address - Country:US
Practice Address - Phone:305-933-8465
Practice Address - Fax:305-933-0797
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-05-20
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Provider Licenses
StateLicense IDTaxonomies
FLME17852207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047008200Medicaid
FL047008200Medicaid
FL91930ZMedicare PIN
FL91930WMedicare PIN