Individual
DONALD JAMES MADDACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
901 VENETIA BAY BLVD STE 110, VENICE, FL 34285-8042
(941) 484-4778
(941) 485-8063
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS17632
FL
208D00000X
General Practice Physician
02001180
IN
Other
Enumeration date
06/08/2005
Last updated
04/01/2024
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