Organization
DOMINGUEZ COMMUNITY CENTER CORP.
Active
Parent organization
DOMINGUEZ COMMUNITY CENTER CORP.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOMINGUEZ COMMUNITY CENTER CORP.
Authorized official
MRS. ADANNYS DOMINGUEZ (OWNER)
(305) 744-4525
Entity
Organization
Contact information
Practice address
13205 SW 137TH AVE STE 132, MIAMI, FL 33186-5334
(786) 478-6369
(786) 429-1704
Mailing address
13205 SW 137TH AVE STE 132, MIAMI, FL 33186-5334
(786) 478-6369
(786) 429-1704
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022727100
—
FL
Enumeration date
10/24/2017
Last updated
10/01/2024
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