Organization
DOMA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSVALDO MARTINEZ (ADMINISTRATOR)
(954) 918-4533
Entity
Organization
Contact information
Practice address
440 E SAMPLE RD STE 107, POMPANO BEACH, FL 33064-4432
(754) 205-2496
(754) 205-5156
Mailing address
4000 N 37TH AVE, HOLLYWOOD, FL 33021-1927
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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