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General NPI Number Information
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NPI Number | 1770308124
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Entity Type | Organization
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Legal Business Name | DOMINGUEZ MEDICAL SERVICE
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 187 AVE LOS ATLETICOS DE SAN GERMAN EDIFICIO RALI SUITE 215
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-974-1384
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Fax | 787-651-3343
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Provider Business Mailing Address
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Address Line | URB. MONTE VERDE C 14 CALLE FLAMBOYAN
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-974-1384
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ELVIS DOMINGUEZ
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Credential |
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Telephone | 939-238-0593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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