Individual
DOMENIC BERMUDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7709 HOKE RD, ENGLEWOOD, OH 45315-9725
(937) 809-2940
(937) 809-2941
Mailing address
7709 HOKE RD, ENGLEWOOD, OH 45315-9725
(937) 809-2940
(937) 809-2941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
APP-000112838
OH
363AM0700X
Medical Physician Assistant
Primary
50.005193RX
OH
363AS0400X
Surgical Physician Assistant
50.005193RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243891
—
OH
05
—
0270942
—
OH
Enumeration date
08/23/2017
Last updated
10/03/2025
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