Individual
DR. OSVALDO ANTONIO FERNANDEZ DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3621 SW 107TH AVE, MIAMI, FL 33165-3636
(855) 226-6633
Mailing address
3621 SW 107TH AVE, MIAMI, FL 33165-3636
(855) 226-6633
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME106374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002095400
—
FL
Enumeration date
02/20/2010
Last updated
01/09/2023
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