Individual
LISA MARIE DOMARADZKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 NW 10TH AVE, MIAMI, FL 33136-1015
(305) 243-6387
(305) 243-6372
Mailing address
1600 NW 10TH AVE, MIAMI, FL 33136-1015
(305) 243-6387
(305) 243-6372
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME144908
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2014
Last updated
06/22/2020
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