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1326287657
JONATHAN DOMICO
CLEARWATER, FL
NPI
1326287657
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA9104899)
Enumeration Date
2009-02-10
Last Update Date
2009-02-10
Business Address
-- JONATHAN DOMICO PA-C
300 PINELLAS ST
CLEARWATER, FL 33756-3804
Phone number: 727-461-8537
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Mailing Address
-- JONATHAN DOMICO PA-C
PO BOX 850001
ORLANDO, FL 32885-0001
Phone number: 904-482-1070
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