Dominguez, Carlos Lorenzo
Dominguez, Carlos Lorenzo is an sole proprietor health care provider with primary practice located at 1857 Providence Blvd , Deltona FL 32725-3811. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Dominguez, Carlos Lorenzo can be contacted via phone (386) 789-8544.Contact Information
Primary practice address
1857 Providence Blvd
Deltona FL 32725-3811
Phone: (386) 789-8544
Fax: (321) 249-9432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME0072352 | Florida |
Profile Details
| NPI number | 1104864768 |
|---|---|
| LBN Legal business name | Dominguez, Carlos Lorenzo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 3rd, 2006 |
| Last updated | Jan 25th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104864768 | NPPES |
| Florida | MEDICAID | 252750200 |
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