Doma MD LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DOMA MD LLC

Practice address

440 E Sample Rd Ste 107
Pompano Beach, FL 33064-4432

Phone

(754) 205-2496

Fax

(754) 205-5156

NPI assigned

Aug 9, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Osvaldo Martinez

Title

Administrator

Phone

(954) 918-4533

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1790330397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N 37TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E SAMPLE RD STE 107",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330644432",
            "telephone_number": "754-205-2496",
            "fax_number": "754-205-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "OSVALDO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-918-4533",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.