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Individual

DR. PATRICK W DOMKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2222 S HARBOR CITY BLVD STE 430, MELBOURNE, FL 32901-5591
(321) 344-8746
(321) 339-1932
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 344-8746

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME89469
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122937200
FL
01
239538
WELLCARE
FL
05
269280500
FL
01
3456730
AETNA
FL
01
37840
BLUE CROSS BLUE SHIELD
FL
01
6039513001
CIGNA
FL
01
7801535
AETNA
FL
01
P00217825
RAILROAD MEDICARE
FL
01
XG958
HFMG
FL
Enumeration date
11/09/2005
Last updated
06/29/2026
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