Individual
FELIPE EMILIO DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3030 VENTURE LN, STE. 108, MELBOURNE, FL 32934-8172
(321) 253-5197
(321) 253-5199
Mailing address
3030 VENTURE LN, STE 108, MELBOURNE, FL 32934-8172
(321) 253-5197
(321) 253-5199
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
ME48985
FL
291U00000X
Clinical Medical Laboratory
Primary
ME 48985
FL
Other
Enumeration date
03/29/2007
Last updated
11/10/2022
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