Organization
DONNA J. BADOLATO, MD, PA
Active
Other names
Donna Johnston, MD.
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA C. JOHNSTON M.D. (OWNER)
(321) 751-7041
Entity
Organization
Contact information
Practice address
8061 SPYGLASS HILL RD., SUITE 102, MELBOURNE, FL 32940
(321) 751-7041
(321) 751-7042
Mailing address
8061 SPYGLASS HILL RD., SUITE 102, MELBOURNE, FL 32940
(321) 751-7041
(321) 751-7042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME76813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
FL
01
—
49715
BLUE CROSS BLUE SHIELD
FL
01
—
7158131
AETNA INSURANCE
FL
Enumeration date
04/13/2007
Last updated
05/21/2020
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