Organization
RICARDO DOMINGUEZ, MD, PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO DOMINGUEZ M.D (PRESIDENT)
(305) 693-7412
Entity
Organization
Contact information
Practice address
777 E 25TH ST, SUITE 303, HIALEAH, FL 33013-3825
(305) 693-7412
(305) 693-7416
Mailing address
15211 FINTRY PL, MIAMI LAKES, FL 33016-1424
(305) 819-3077
(305) 827-0636
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME87966
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267701600
—
FL
Enumeration date
07/22/2006
Last updated
10/21/2009
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