| Angelo S Domingo Jr Llc | |
|
9926 52nd St E Parrish FL 34219-4417 | |
| (203) 668-6318 | |
| Not Available |
| Full Name | Angelo S Domingo Jr Llc |
|---|---|
| Speciality | Psychologist |
| Location | 9926 52nd St E, Parrish, Florida |
| Authorized Official Name and Position | Angelo S Domingo (MANAGING MEMBER) |
| Authorized Official Contact | 2036686318 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angelo S Domingo Jr Llc 9926 52nd St E Parrish FL 34219-4417 Ph: (203) 668-6318 | Angelo S Domingo Jr Llc 9926 52nd St E Parrish FL 34219-4417 Ph: (203) 668-6318 |
| NPI Number | 1285877795 |
|---|---|
| Provider Enumeration Date | 04/14/2009 |
| Last Update Date | 04/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285877795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY7379 (Florida) | Primary |
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