Healthcare Provider Details

I. General information

NPI: 1952362345
Provider Name (Legal Business Name): MARIA S DOMINGUEZ PASCUAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR # 2 KM 39.7 URB COLLAZO
VEGA BAJA PR
00693
US

IV. Provider business mailing address

CALLE MAR DEL NORTE CASA #763 PASEOS LOS CORALES II
DORADO PR
00646-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-807-8302
  • Fax: 787-807-7218
Mailing address:
  • Phone: 787-807-8302
  • Fax: 787-807-7218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14458
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: