Provider Demographics
NPI:1124257290
Name:KORANDO, DONNA L (PA-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:KORANDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 E NINE MILE RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-7747
Mailing Address - Country:US
Mailing Address - Phone:850-479-4791
Mailing Address - Fax:850-494-2260
Practice Address - Street 1:1921 E NINE MILE RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-7747
Practice Address - Country:US
Practice Address - Phone:850-479-4791
Practice Address - Fax:850-494-2260
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9104810363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant