Dominguez, Jose Carlos
Dominguez, Jose Carlos is an individual health care provider with primary practice located at 3645 Madaca Ln , Tampa FL 33618-2048. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Dominguez, Jose Carlos can be contacted via phone (813) 969-0116.Contact Information
Primary practice address
3645 Madaca Ln
Tampa FL 33618-2048
Phone: (813) 969-0116
Fax: (813) 969-3794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | ME00555091 | Florida |
Profile Details
| NPI number | 1871554774 |
|---|---|
| LBN Legal business name | Dominguez, Jose Carlos |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Oct 26th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871554774 | NPPES |
| Florida | MEDICAID | 059950600 |
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