MEDICARE: EDUARDO DOMINGUEZ SANCHEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-26-537109	FL

General Provider Information

NPI Number	:	1275465148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDUARDO DOMINGUEZ SANCHEZ

Provider Business Mailing Address
First Line	:	21945 SW 107TH AVE
Second Line	:	A 307
City	:	GOULDS
State	:	FL
Zip	:	33170-3156
Country	:	US
Telephone Number	:	786-447-8839
Fax Number	:

Provider Business Practice Location Address
First Line	:	21945 SW 107TH AVE
Second Line	:
City	:	GOULDS
State	:	FL
Zip	:	33170-3156
Country	:	US
Telephone Number	:	786-447-8839
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ EDUARDO DOMINGUEZ SANCHEZ ” Practice Location

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