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NPI Code Detail

MEDICARE: DR. RENATO CARLOS DOMINGUEZ MD

MEDICARE:  DR. RENATO CARLOS DOMINGUEZ  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician15709PR
2207R00000XInternal Medicine PhysicianME 96462FL

General Provider Information

NPI Number : 1851408538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENATO CARLOS DOMINGUEZ MD
Provider Business Mailing Address
First Line : 285 NW 27TH AVE STE 14
Second Line :
City : MIAMI
State : FL
Zip : 33125-5133
Country : US
Telephone Number : 305-642-4444
Fax Number : 305-642-4499
Provider Business Practice Location Address
First Line : 285 NW 27TH AVE STE 14
Second Line :
City : MIAMI
State : FL
Zip : 33125-5133
Country : US
Telephone Number : 305-642-4444
Fax Number : 305-642-4499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 05/21/2013

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Directions to “ DR. RENATO CARLOS DOMINGUEZ MD” Practice Location

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