Individual provider · NPI-1

Jose Carlos Dominguez Jr., MD

Allergy & Immunology · Tampa, FL

NPI number1871554774
StatusActive
Last updated in NPPESOct 26, 2011

Details

NPI
1871554774
Entity type
Individual (NPI-1)
Name
Jose Carlos Dominguez Jr.
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Mar 30, 2006
Last updated
Oct 26, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207K00000X Allergy & ImmunologyME00555091FLYes

Practice location

3645 Madaca Ln
Tampa, FL 33618-2048

Phone 813-969-0116 · Fax 813-969-3794

Mailing address

3645 Madaca Ln
Tampa, FL 33618-2048

Phone 813-969-0116 · Fax 813-969-3794

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