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Organization

JUAN C. DOMINGO, M.D.,P.A.

Active
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Organization

JUAN C. DOMINGO, M.D.,P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUAN CARLOS DOMINGO M.D. (CEO)
(239) 673-9861
Entity
Organization

Contact information

Practice address
900 SW PINE ISLAND ROAD, UNIT 208, CAPE CORAL, FL 33991-0000
(239) 673-9861
(239) 673-9886
Mailing address
900 SW PINE ISLAND ROAD, UNIT 208, CAPE CORAL, FL 33991-0000
(239) 673-9861
(239) 673-9886

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME52059
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0405271
UNITED HEALTHCARE
FL
05
—
046503900
—
FL
01
—
07319
BC/BS
FL
01
—
4909698
CIGNA
FL
01
—
5194010
AETNA
FL
Enumeration date
03/17/2009
Last updated
03/17/2009
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