Madonna, Dino

Madonna, Dino is an individual health care provider with primary practice located at 601 E Dixie Ave Medical Plaza 901, Leesburg FL 34748-5953. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Facial Plastic Surgery is his primary health care specialty. Madonna, Dino can be contacted via phone (352) 728-2404.

Contact Information

Primary practice address
601 E Dixie Ave Medical Plaza 901 Leesburg FL 34748-5953
Phone: (352) 728-2404
Fax: (352) 787-7401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X ME78248 Florida
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X ME78248 Florida

Profile Details

NPI number 1780684399
LBN Legal business name Madonna, Dino
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Jul 16th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780684399 NPPES
Florida MEDICAID 256975200

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