Healthcare Provider Details

I. General information

NPI: 1275651234
Provider Name (Legal Business Name): DOMINIC C MAGGIO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST SUITE 200
MIAMI FL
33125-1673
US

IV. Provider business mailing address

1321 NW 14TH ST SUITE 200
MIAMI FL
33125-1673
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-0220
  • Fax: 305-545-0790
Mailing address:
  • Phone: 305-324-0220
  • Fax: 305-545-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DOMINIC C MAGGIO
Title or Position: OWNER-PRESIDENT
Credential: MD
Phone: 305-324-0220