Individual
OSMANI DOMINGUEZ FUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
20022 NW 58TH CT, HIALEAH, FL 33015-4903
(786) 389-8456
Mailing address
20022 NW 58TH CT, HIALEAH, FL 33015-4903
(786) 389-8456
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-683
FL
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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