Active NPI
Juan C. Domingo, M.D.,P.a.
- Internal Medicine Physician
- Cape Coral, FL
National Provider Identifier
1669613998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME52059
- Legal business name
- JUAN C. DOMINGO, M.D.,P.A.
- Practice address
- 900 SW Pine Island Road
Unit 208
Cape Coral, FL 33991-0000 - Phone
- (239) 673-9861
- Fax
- (239) 673-9886
- NPI assigned
- Mar 17, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Juan Carlos Domingo, M.D.
- Title
- Ceo
- Phone
- (239) 673-9861
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME52059 | FL | Primary |
Addresses
Primary practice location
900 SW Pine Island Road
Unit 208
Cape Coral, FL 33991-0000
Mailing address
900 SW Pine Island Road
Unit 208
Cape Coral, FL 33991-0000
Phone (239) 673-9861
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0405271 | Other | FL | UNITED HEALTHCARE |
| 046503900 | Medicaid | FL | |
| 07319 | Other | FL | BC/BS |
| 5194010 | Other | FL | AETNA |
| 4909698 | Other | FL | CIGNA |
National Provider Directory
National Provider DirectoryLocations
900 SW Pine Island Rd
Ste 208
Cape Coral, FL 33991
Phone (239) 673-9861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237248000000",
"number": "1669613998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 SW PINE ISLAND ROAD",
"address_2": "UNIT 208",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339910000",
"telephone_number": "239-673-9861",
"fax_number": "239-673-9886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SW PINE ISLAND ROAD",
"address_2": "UNIT 208",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339910000",
"telephone_number": "239-673-9861",
"fax_number": "239-673-9886"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JUAN C. DOMINGO, M.D.,P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-17",
"last_updated": "2009-03-17",
"status": "A",
"authorized_official_last_name": "DOMINGO",
"authorized_official_first_name": "JUAN",
"authorized_official_middle_name": "CARLOS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "239-673-9861",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME52059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0405271",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046503900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "07319",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5194010",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4909698",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.