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Individual
THOMAS JOSEPH DOMINGUEZ IV
Active
Individual
THOMAS JOSEPH DOMINGUEZ IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
4269
CT
363AS0400X
Surgical Physician Assistant
Primary
PA9113032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105929600
—
FL
05
—
131763800
—
FL
01
—
UR442
MEDICARE HF
FL
Enumeration date
09/11/2018
Last updated
06/29/2026
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