Bacon, Donna Louise

Bacon, Donna Louise is an sole proprietor health care provider with primary practice located at 1282 Us Highway 1 Ste 1 , Rockledge FL 32955-2747. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bacon, Donna Louise can be contacted via phone (321) 631-3693.

Contact Information

Primary practice address
1282 Us Highway 1 Ste 1 Rockledge FL 32955-2747
Phone: (321) 631-3693
Fax: (321) 631-7618
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME71719 Florida

Profile Details

NPI number 1215934476
LBN Legal business name Bacon, Donna Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2005
Last updated Oct 31st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215934476 NPPES
Florida MEDICAID 101544100

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