Individual
RONALD RICHARD DOMESCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME57239
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME57239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063394100
—
FL
01
—
ME57239
MEDICAL LICENSE
FL
Enumeration date
06/16/2005
Last updated
11/11/2016
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