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General NPI Number Information
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NPI Number | 1568471886
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Entity Type | Individual
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Provider Name | EMILIO DOMINGUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 36819 EILAND BLVD STE 1
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-0600
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Country | US
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Telephone | 813-778-0288
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Fax | 813-355-5041
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Provider Business Mailing Address
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Address Line | 38135 MARKET SQUARE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542
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Country | US
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Telephone | 813-528-4975
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME63075
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License Number State | FL
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