Individual
DR. MICHAEL EUGENE DOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
18203 SANDY POINTE DR, TAMPA, FL 33647
(727) 804-3668
Mailing address
5509 GRAND BLVD STE 203, NEW PORT RICHEY, FL 34652-3836
(727) 572-5449
(727) 844-5425
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390456300
—
FL
Enumeration date
05/06/2006
Last updated
11/07/2019
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