Provider Demographics
NPI:1487027637
Name:NELSON, DONOFFA ELISABETH (DO)
Entity type:Individual
Prefix:
First Name:DONOFFA
Middle Name:ELISABETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11916 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3700
Mailing Address - Country:US
Mailing Address - Phone:788-644-7998
Mailing Address - Fax:
Practice Address - Street 1:9401 SW HIGHWAY 200 BLDG 90
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9612
Practice Address - Country:US
Practice Address - Phone:352-671-2320
Practice Address - Fax:352-820-5690
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13504207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine