Jack Donnelly, is a
Behavior Technician based in Gainesville, Florida. Jack Donnelly is licensed to practice in * (Not Available) (license number ) and his current practice location is
1408 Nw 6th St, Gainesville, Florida. He can be reached at his office (for appointments etc.) via phone at
(352) 373-4411.
NPI number for Jack Donnelly is 1366918138 and his current mailing address is 1408 Nw 6th St, Gainesville, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1366918138.
Healthcare Provider's Profile
| Full Name | Jack Donnelly |
|---|
| Gender | Male |
|---|
| Speciality | Behavior Technician |
|---|
| Location | 1408 Nw 6th St, Gainesville, Florida |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1366918138
- Provider Enumeration Date: 10/19/2018
- Last Update Date: 09/20/2019
Medical Identifiers
Medical identifiers for Jack Donnelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366918138 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 222Q00000X | Developmental Therapist | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Donnelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack Donnelly,
1408 Nw 6th St,
Gainesville, FL 32601-4020
Ph: (352) 373-4411 | Jack Donnelly,
1408 Nw 6th St,
Gainesville, FL 32601-4020
Ph: (352) 373-4411 |
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