Organization
FELIPE E. DOMINGUEZ, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIPE E DOMINGUEZ MD (PRESIDENT)
(321) 795-1321
Entity
Organization
Contact information
Practice address
3030 VENTURE LANE, STE 108, MELBOURNE, FL 32934
(321) 253-5197
(321) 253-5199
Mailing address
14040 US HIGHWAY 1, SEBASTIAN, FL 32958
(772) 581-0890
(772) 581-0591
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
ME 48985
FL
Other
Enumeration date
09/01/2011
Last updated
12/18/2014
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