NPIMap

Organization Active NPI

Domahn, Inc

  • Specialist
  • Port Charlotte, FL
National Provider Identifier
1982858049
Registry record updated Nov 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA34283 Issued in FL
Legal business name
DOMAHN, INC
Practice address
3109 Tamiami TRL
Port Charlotte, FL 33952-8046
Phone
(941) 235-1500
Fax
(941) 235-1508
NPI assigned
Nov 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2008

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

Authorized official

Name
Mr. Mitho Larose Amilcar, PRESIDENT
Title
Adminstrator
Phone
(941) 235-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X MA34283 FL Primary

Addresses

Primary practice location

3109 Tamiami TRL
Port Charlotte, FL 33952-8046

Mailing address

3109 Tamiami TRL
Port Charlotte, FL 33952-8046
Phone (941) 235-1500

National Provider Directory

National Provider Directory

Locations

3109 Tamiami Trl
Port Charlotte, FL 33952
Phone (941) 235-1500

NPI Registry JSON

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

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226707200000",
    "number": "1982858049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528046",
            "telephone_number": "941-235-1500",
            "fax_number": "941-235-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528046",
            "telephone_number": "941-235-1500",
            "fax_number": "941-235-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMAHN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-15",
        "last_updated": "2008-11-15",
        "status": "A",
        "authorized_official_last_name": "AMILCAR",
        "authorized_official_first_name": "MITHO",
        "authorized_official_middle_name": "LAROSE",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "941-235-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA34283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; 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.