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Individual

GABRIEL DOMENECH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 NW 82ND AVE STE 201, PLANTATION, FL 33324-1854
(954) 314-7100
(954) 324-7133
Mailing address
1515 WINDJAMMER WAY, HOLLYWOOD, FL 33019-5035
(954) 253-3114

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
78342
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
198641
WELLCARE
FL
01
263268
AVMED
FL
01
46944
BCBS
FL
01
5379008
CIGNA
FL
01
5733554
AETNA
FL
01
9781
DIMENSION HEALTH
FL
01
F00215771101
UNITED
FL
01
P01391282
RR MEDICARE
FL
01
P1019778
FREEDOM
FL
01
P958304
OPTIMUM
FL
01
QMP000005289550
MOLINA
FL
Enumeration date
09/13/2005
Last updated
03/13/2025
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