Organization
GERALD H DOMINGUEZ, MD PA
Active
Organization
GERALD H DOMINGUEZ, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD HENRY DOMINGUEZ MD (PRESIDENT)
(813) 872-7987
Entity
Organization
Contact information
Practice address
4710 N HABANA AVE, STE #201, TAMPA, FL 33614-7146
(813) 872-7987
(813) 875-1832
Mailing address
4710 N HABANA AVE, STE #201, TAMPA, FL 33614-7146
(813) 872-7987
(813) 875-1832
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0008716
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043129000
—
FL
Enumeration date
10/05/2010
Last updated
10/05/2010
Update your record
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