Individual
GABRIEL JOSE DOMINGUEZ-PANTOJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 E ALTAMONTE DR, ALTAMONTE SPRINGS, FL 32701-4802
(407) 303-2200
Mailing address
111 S MCKINLEY ST APT 4311, LITTLE ROCK, AR 72205-2069
(989) 429-3177
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-11820
AR
207P00000X
Emergency Medicine Physician
Primary
ME139214
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
06/14/2019
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