Individual
DOMINICK MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(321) 841-1893
(321) 841-1757
Mailing address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(321) 841-1893
(321) 841-1757
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME109643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197800
—
FL
01
—
30075
STATE LICENSE
AL
01
—
ME109643
FLORIDA MEDICAL LICENSE
FL
Enumeration date
08/17/2007
Last updated
11/17/2023
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