Individual
DOMENIKA ALEJANDRA ORTIZ REQUENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-8381
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME155129
FL
Other
Enumeration date
10/11/2018
Last updated
09/26/2024
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