Individual
MIRIAM BATULE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 CALLE SERGIO CUEVAS BUSTAMANTE ESQ. AVE DOMENECH, SAN JUAN, PR 00918
(305) 587-0283
Mailing address
550 CALLE SERGIO CUEVAS BUSTAMANTE ESQ. AVE DOMENECH, SAN JUAN, PR 00918
(305) 587-0283
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
24565
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/25/2024
Last updated
08/22/2025
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