Individual
DONNA L DUCILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6037 KIMBERLY BLVD, NORTH LAUDERDALE, FL 33068-2811
(954) 379-8994
Mailing address
1395 NW 167TH ST, 142, MIAMI, FL 33169-5742
(954) 472-2999
(954) 473-8171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS8172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260352700
—
FL
Enumeration date
05/17/2006
Last updated
01/15/2020
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