Individual
DOMENIC VINCENT OTTAIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
(862) 293-1121
Mailing address
PO BOX 864165, ORLANDO, FL 32886-4215
(317) 614-9863
(844) 876-0873
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME0057744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372548100
—
FL
Enumeration date
06/14/2006
Last updated
10/24/2019
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