Manuel Dominguez Md Pa | |
1540 Washington Ave Miami Beach FL 33139-7801 | |
(305) 532-4122 | |
Not Available |
Full Name | Manuel Dominguez Md Pa |
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Speciality | Internal Medicine |
Location | 1540 Washington Ave, Miami Beach, Florida |
Authorized Official Name and Position | Manuel Dominguez (OWNER) |
Authorized Official Contact | 3055324122 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Manuel Dominguez Md Pa 1540 Washington Ave Miami Beach FL 33139-7801 Ph: () - | Manuel Dominguez Md Pa 1540 Washington Ave Miami Beach FL 33139-7801 Ph: (305) 532-4122 |
NPI Number | 1922672294 |
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Provider Enumeration Date | 05/19/2021 |
Last Update Date | 06/22/2021 |
Medicare PECOS PAC ID | 1557765310 |
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Medicare Enrollment ID | O20210802002540 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922672294 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Manuel Dominguez |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1891831004 PECOS PAC ID: 1850541236 Enrollment ID: I20121019000461 |
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