| Humberto A Dominguez Md Pa | |
|
70 Fox Ridge Ct Suite A Debary FL 32713-2752 | |
| (386) 668-4411 | |
| (386) 668-8688 |
| Full Name | Humberto A Dominguez Md Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 70 Fox Ridge Ct, Debary, Florida |
| Authorized Official Name and Position | Humberto A Dominguez (OWNER) |
| Authorized Official Contact | 3866684411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Humberto A Dominguez Md Pa 70 Fox Ridge Ct Suite A Debary FL 32713-2752 Ph: (386) 668-4411 | Humberto A Dominguez Md Pa 70 Fox Ridge Ct Suite A Debary FL 32713-2752 Ph: (386) 668-4411 |
| NPI Number | 1144538364 |
|---|---|
| Provider Enumeration Date | 09/22/2010 |
| Last Update Date | 06/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144538364 | NPI | - | NPPES |
| 038066100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME29577 (Florida) | Primary |
Potenciano Gonzales Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 62 Spring Vista Dr Ste 100, Debary, FL 32713 Phone: 386-668-8559 | |
Medical Home Alliance Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 173 N Charles Richard Beall Blvd Ste 106, Debary, FL 32713 Phone: 407-845-0330 | |
Premier Physician Associates, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Pond Ct Ste 301, Debary, FL 32713 Phone: 818-575-0204 | |
Florida Injury Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 432 N Pine Meadow Dr, Debary, FL 32713 Phone: 386-742-7312 | |
Spahana Health, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Spring Vista Dr, Debary, FL 32713 Phone: 386-279-3087 Fax: 386-516-6136 | |
Potenciano D Gonzales Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Fox Ridge Ct, Suite B, Debary, FL 32713 Phone: 386-668-8559 Fax: 386-668-8560 |