Dominguez, Carlos Lorenzo

Dominguez, Carlos Lorenzo is an sole proprietor health care provider with primary practice located at 1857 Providence Blvd , Deltona FL 32725-3811. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Dominguez, Carlos Lorenzo can be contacted via phone (386) 789-8544.

Contact Information

Primary practice address
1857 Providence Blvd Deltona FL 32725-3811
Phone: (386) 789-8544
Fax: (321) 249-9432
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0072352 Florida

Profile Details

NPI number 1104864768
LBN Legal business name Dominguez, Carlos Lorenzo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 3rd, 2006
Last updated Jan 25th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104864768 NPPES
Florida MEDICAID 252750200

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