Carlos Lorenzo Dominguez, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0072352 Issued in FL

Practice address

1857 Providence Blvd
Deltona, FL 32725-3811

Phone

(386) 789-8544

Fax

(321) 249-9432

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Daytona Home health agency, Ormond Beach, FL, CCN 108284
• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
• Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carlos L Dominguez MD PA

  • Internal Medicine Physician
  • Deltona, FL
  • NPI 1730452970
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Health Services, LLC.

  • Home Health Agency
  • Ormond Beach, FL
  • NPI 1013081215
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  • General Acute Care Hospital
  • Orange City, FL
  • NPI 1700978558
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  • Internal Medicine Physician
  • Orange City, FL
  • NPI 1902095078

  Hospital

  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1104864768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4876 RED BRICK RUN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717108",
            "telephone_number": "386-789-8544",
            "fax_number": "321-249-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857 PROVIDENCE BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327253811",
            "telephone_number": "386-789-8544",
            "fax_number": "321-249-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "CARLOS",
        "middle_name": "LORENZO",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0072352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252750200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Dhanani
• Diabetes Store, Incorporated
• Ifrain Diaz
• Jeannine A. Difranco, ATC, CSCS
• Michelle Doglione
• Jamile Marie Dominguez
• Tyshonda Downing
• Dr Vincent T Mattiello
• Dream Chasers2
• Samantha Duckett, CHIROPRACTOR

• Internal Medicine Physician in Deltona, FL
• Providers in Deltona, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.