Individual
DOMENICA MARCANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1431 SW 1ST AVE, OCALA, FL 34471
(352) 401-1000
Mailing address
1090 NE 84TH ST, MIAMI, FL 33138-3420
(352) 401-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101245230
VA
207P00000X
Emergency Medicine Physician
Primary
ME111770
FL
390200000X
Student in an Organized Health Care Education/Training Program
0116018214
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004444400
—
FL
05
—
1033310412
—
VA
01
—
14J65
BCBS
FL
Enumeration date
05/31/2007
Last updated
03/20/2019
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