Dr. Ivan Dominguez, MD
Healthcare Provider in San Juan, Puerto Rico
1104070705- Practice location
- 1462 Calle Prof Augusto Rodriguez, San Juan, PR 00909-2199
- Phone
- 787-727-6060
- Fax
- —
- Last updated
- December 20, 2019
Ivan Dominguez is a Healthcare Provider based in San Juan, PR. Ivan Dominguez practices in San Juan, PR and has the professional credentials of MD. The NPI Number for Ivan Dominguez is 1104070705 and holds a License No. 265300 (NY). The current practice location address for Ivan Dominguez is 1462 Calle Prof Augusto Rodriguez, San Juan, PR 00909-2199 and can be reached out via phone at 787-727-6060.
Provider Profile Details
- NPI Number
- 1104070705
- Provider Name
- Ivan Dominguez
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1462 Calle Prof Augusto Rodriguez, San Juan, PR 00909-2199
- Phone Number
- 787-727-6060
- Primary Taxonomy
- Healthcare Provider · 2086S0129X
- Sole Proprietor
- No
- Provider Enumeration Date
- November 10, 2008
- Last Update Date
- December 20, 2019
- Certification Date
- December 20, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1462 Calle Prof Augusto Rodriguez
San Juan, PR 00909-2199 - City
- San Juan
- State
- Puerto Rico
- Zip
- 00909-2199
- Phone Number
- 787-727-6060
Provider Business Mailing Address Details
- Address
- Po Box 11137
San Juan, PR 00910-2237 - City
- San Juan
- State
- PR
- Zip
- 00910-2237
- Phone Number
- 787-641-1616
License Information
- License Number (1)
- 265300
- License State (1)
- NY
- License Number (2)
- 021391
- License State (2)
- PR
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Healthcare Providers near San Juan, PR
View all Healthcare Providers in San Juan →Frequently Asked Questions
What is the NPI number of Dr. Ivan Dominguez, MD?
The NPI number of Dr. Ivan Dominguez, MD is 1104070705. It was assigned on November 10, 2008 and is currently active in the NPPES registry.
What is the specialty of Dr. Ivan Dominguez, MD?
Dr. Ivan Dominguez, MD is registered under the primary taxonomy Healthcare Provider (code 2086S0129X), licensed in NY under license number 265300.
Where does Dr. Ivan Dominguez, MD practice?
The practice location is 1462 Calle Prof Augusto Rodriguez, San Juan, PR 00909-2199. The office can be reached at 787-727-6060 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104070705 directly on the NPPES registry website.