Organization
JOSE C DOMINGUEZ MD PA
Active
Organization
JOSE C DOMINGUEZ MD PA
Active
Other names
Jose C Dominguez MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE CARLOS DOMINGUEZ SR. M.D. (PRESIDENT)
(813) 877-9449
Entity
Organization
Contact information
Practice address
4600 N HABANA AVE, SUITE 20, TAMPA, FL 33614-7123
(813) 877-9449
(813) 877-9502
Mailing address
4600 N HABANA AVE, SUITE 20, TAMPA, FL 33614-7123
(813) 877-9449
(813) 877-9502
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME12573
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043180000
—
FL
Enumeration date
12/22/2009
Last updated
01/04/2010
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