Organization
EASTERN MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTIAN DOMINGUEZ (PRESIDENT)
(305) 392-0765
Entity
Organization
Contact information
Practice address
8900 CORAL WAY, SUITE 202, MIAMI, FL 33165-2075
(305) 392-0765
Mailing address
8900 CORAL WAY, SUITE 202, MIAMI, FL 33165-2075
(305) 392-0765
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
HCC11007
FL
Other
Enumeration date
05/04/2017
Last updated
09/11/2023
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