Individual
DR. DAVID E. DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 CLASSIC CT STE 104, MELBOURNE, FL 32940-8279
(321) 610-8939
Mailing address
640 CLASSIC CT STE 104, MELBOURNE, FL 32940-8279
(321) 610-8939
(321) 622-8728
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME110378
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
ME110378
FL
2086S0127X
Trauma Surgery Physician
ME110378
FL
Other
Enumeration date
04/03/2009
Last updated
07/22/2024
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