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General NPI Number Information
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NPI Number | 1316862584
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Entity Type | Organization
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Legal Business Name | DOMENECH MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | BO. COTTO MABU CARR 189, R922 KO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-363-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 219 AVE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3362
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Country | US
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Telephone | 787-363-6670
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN DOMENECH
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Credential | MD
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Telephone | 787-363-6670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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