Individual
MRS. ILIA M DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
AVE AGUSTIN RAMOS CALERO INT 111 BZN 737, ISABELA, PR 00662
(787) 830-2765
(787) 830-0465
Mailing address
PO BOX 962, AGUADA, PR 00602-0962
(787) 241-8886
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12514
PR
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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