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General NPI Number Information
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NPI Number | 1699121301
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Entity Type | Organization
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Legal Business Name | AIRS GLOBAL & THERAPEUTIC SERVICES INC.
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 1005 SW 10TH ST SUITE 103
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City | OCALA
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State | FL
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Zip | 34471-0306
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Country | US
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Telephone | 352-512-0222
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Fax | 352-512-0128
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Provider Business Mailing Address
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Address Line | 1005 SW 10TH ST SUITE 103
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City | OCALA
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State | FL
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Zip | 34471-0306
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Country | US
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Telephone | 352-512-0222
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Fax | 352-512-0128
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | DR. MARISELA DOMINGUEZ
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Credential | MD
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Telephone | 352-512-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME102787
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License Number State | FL
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