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Individual

MR. ROBERT ALLEN DONALDSON JR. JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
612 SW HOGAN ST, PORT SAINT LUCIE, FL 34983-8765
(772) 812-4142
Mailing address
612 SW HOGAN ST, PORT SAINT LUCIE, FL 34983-8765
(772) 812-4142

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
D543-761-90-148-0
FL
376J00000X
Homemaker
D543-761-90-148-0
FL

Other

Enumeration date
08/27/2024
Last updated
08/27/2024
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