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General NPI Number Information
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NPI Number | 1306431218
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Entity Type | Individual
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Provider Name | DAVID DIGIANDOMENICO PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 443 W COUNTY ROAD 419 STE 1041
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City | CHULUOTA
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State | FL
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Zip | 32766-9520
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Country | US
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Telephone | 407-366-2890
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Fax | 407-542-1012
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Provider Business Mailing Address
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Address Line | 382 PALM DR
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City | OVIEDO
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State | FL
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Zip | 32765-9532
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Country | US
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Telephone | 954-243-4239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | PA9114085
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License Number State | FL
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