Domingo, Maxfelonilo A

Domingo, Maxfelonilo A is an individual health care provider with primary practice located at 760 Se 5Th Terrace , Crystal River FL 34429-4852. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Domingo, Maxfelonilo A can be contacted via phone (352) 795-4165.

Contact Information

Primary practice address
760 Se 5Th Terrace Crystal River FL 34429-4852
Phone: (352) 795-4165
Fax: (352) 795-3659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME0043605 Florida

Profile Details

NPI number 1235326984
LBN Legal business name Domingo, Maxfelonilo A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2007
Last updated Oct 8th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235326984 NPPES
Florida MEDICAID 000755600
Florida Other 11379665
Florida Other 77940
Florida Other CF1416
Florida Other ME43605
Florida Other 77940
Florida Other 79947
Florida Other 06004119
Florida Other 269859500
Florida Other 592123944

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