Organization
SR DIRECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DOMINGUEZ (CEO)
(786) 548-7589
Entity
Organization
Contact information
Practice address
390 NE 191ST ST STE 8952, MIAMI, FL 33179-3899
(786) 697-1315
Mailing address
390 NE 191ST ST STE 8952, MIAMI, FL 33179-3899
(786) 697-1315
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
03/18/2025
Last updated
05/19/2025
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