Individual
DR. IVAN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1462 CALLE PROF AUGUSTO RODRIGUEZ, SAN JUAN, PR 00909-2199
(787) 727-6060
Mailing address
PO BOX 11137, SAN JUAN, PR 00910-2237
(787) 641-1616
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
021391
PR
2086S0129X
Vascular Surgery Physician
265300
NY
Other
Enumeration date
11/10/2008
Last updated
12/20/2019
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