# 3D SPORTS MEDICINE & JOINT CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** 3D Sports Medicine & Orthopaedic Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316351372
- **Authorized official:** DR. DAVID E DOMINGUEZ M.D. (OWNER)
- **Authorized official phone:** (321) 610-8939

## Contact information

- **Practice address:** 640 CLASSIC CT STE 104, MELBOURNE, FL 32940-8279
- **Practice address phone:** (321) 610-8939
- **Practice address fax:** (321) 622-8728
- **Mailing address:** 640 CLASSIC CT STE 104, MELBOURNE, FL 32940-8279
- **Mailing address phone:** (321) 610-8939
- **Mailing address fax:** (321) 622-8728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME110378 | FL | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | ME110378 | FL | — |

## Other

- **Enumeration date:** 06/18/2014
- **Last updated:** 03/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 123405600 | — | FL |