Individual
MR. EDDY DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1535 SW 122ND AVE, APT 3, MIAMI, FL 33184-2837
(786) 470-4698
Mailing address
1535 SW 122ND AVE, APT 3, MIAMI, FL 33184-2837
(786) 470-4698
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA46952
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA46952
STATE LICENSE
FL
Enumeration date
09/28/2011
Last updated
09/28/2011
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