| Dr. Salvatore Didomenico Dcpa | |
|
7466 Edenmore Street Lakewood Ranch FL 34202 | |
| (727) 365-4506 | |
| Not Available |
| Full Name | Dr. Salvatore Didomenico Dcpa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 7466 Edenmore Street, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Salvatore Didomenico (PRESIDENT) |
| Authorized Official Contact | 7273654506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Salvatore Didomenico Dcpa 7466 Edenmore St Lakewood Ranch FL 34202-7900 Ph: (727) 365-4506 | Dr. Salvatore Didomenico Dcpa 7466 Edenmore Street Lakewood Ranch FL 34202 Ph: (727) 365-4506 |
| NPI Number | 1184821860 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 04/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184821860 | NPI | - | NPPES |
| 381824100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | CH0007562 (Florida) | Primary |
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Premiere Gi Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11505 Palmbrush Trl Ste 200, Lakewood Ranch, FL 34202 Phone: 941-334-9040 Fax: 941-334-9030 | |
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