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Individual

MR. DOMINGO A BRACERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH, MBA

Contact information

Practice address
2450 N ORANGE BLOSSOM TRL, KISSIMMEE, FL 34744-2316
(407) 951-2406
Mailing address
13157 PALOMA DR, ORLANDO, FL 32837-8723
(407) 951-2406

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PU 4150
FL
1835P1200X
Pharmacotherapy Pharmacist
Primary
PS25140
FL

Other

Enumeration date
07/11/2013
Last updated
07/11/2013
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