Individual provider Active NPI

Glaymar Dominguez

  • Emergency Medicine Physician
  • Carolina, PR
National Provider Identifier
1497194674
Registry record updated Jan 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
19344 Issued in PR
Practice address
Ave. 65 de Infanteria, Carr.3, KM 8.3
Hospital de la Upr, Dr. Federico Trilla
Carolina, PR 00985
Phone
(787) 757-1800
Fax
(787) 750-0930
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 19344 PR Primary

Addresses

Primary practice location

Ave. 65 de Infanteria, Carr.3, KM 8.3
Hospital de la Upr, Dr. Federico Trilla
Carolina, PR 00985

Mailing address

PO Box 29207 Dept Medicina de Emergencia
San Juan, PR 00929
Phone (787) 757-1800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180626001440 FL Practitioner - Emergency Medicine 2668727090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19344PRMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

35750 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 789-8420

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

12922 Sheldon Rd
Tampa, FL 33626
Phone (813) 282-2850

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1497194674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29207 DEPT MEDICINA DE EMERGENCIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00929",
            "telephone_number": "787-757-1800",
            "fax_number": "787-750-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. 65 DE INFANTERIA, CARR.3, KM 8.3",
            "address_2": "HOSPITAL DE LA UPR, DR. FEDERICO TRILLA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-757-1800",
            "fax_number": "787-750-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "GLAYMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "19344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.