DR. EDGAR E DOMENECH FAGUNDO (NPI# 1386717247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386717247 |
| Entity Type | Individual |
| Full Name | DR. EDGAR E DOMENECH FAGUNDO |
| Credential | MD |
| Practice Address |
Torre Medica San Lucas, Ave. Tito Castro 917 Suite 618 Ponce PR 00730 |
| Mailing Address |
Pmb 137 Po Box 2000 Mercedita PR 00715 |
| Practice Telephone | 7872903333 |
| Practice Fax Number | 7872904444 |
| Mailing Telephone | 7872903333 |
| Mailing Fax Number | 7872904444 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2010-09-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
13247 | PR | Allopathic & Osteopathic Physicians |
| Street Address |
TORRE MEDICA SAN LUCAS, AVE. TITO CASTRO 917 SUITE 618 |
| City | PONCE |
| State | PR |
| Zip Code | 00730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305197 | Hector Ruben Vazquez-torres | General Practice | Valle Alto Calle Cordillera, 1146, Ponce, PR 00730 | 2020-10-27 |
| 1245837327 | Christopher Jose Gotay Serrano | Rehabilitation Counselor | Urb. Santa Teresita Calle Santa Suzana 3711, Ponce, PR 00730 | 2020-10-02 |
| 1194330225 | Lilia Marlene Quintero | General Practice | Urb. Santa Teresita #4994 Santa Paula, Ponce, PR 00730 | 2020-09-15 |
| 1508470691 | Precision Medicine Transport, Corp. | Non-emergency Medical Transport (VAN) | Glenview Gardens Florencia T28, Ponce, PR 00730 | 2020-09-04 |
| 1184241747 | Edgar Luis Rodriguez | Student in an Organized Health Care Education/Training Program | #44 Calle Reina Isabel, Ponce, PR 00730 | 2020-06-30 |
| 1598381501 | Yalisse Linette Rodriguez Torres | Family Medicine | Valle Alto 1794 Llanura, Ponce, PR 00730 | 2020-06-25 |
| 1043833718 | Farmacia Rivera | Pharmacy | Urb. Santa Teresita Calle Santa Genoveva #3251, Esquina Emilio Fagot, Ponce, PR 00730 | 2020-05-28 |
| 1710506464 | Francesca Emily Rios Miller | Pharmacist | Est. Del Golf Club 385, Calle Juan H. Cintron, Ponce, PR 00730 | 2020-04-13 |
| 1689200149 | Centro Ambulatorio De Cirugia Especializada | Clinic/Center | 1000 Av. Tito Castro, Ponce, PR 00730 | 2020-03-17 |
| 1124651773 | Giovanni Lugo | Student in an Organized Health Care Education/Training Program | Calle Reina Isabel #44, Ponce, PR 00730 | 2020-02-21 |
| Find all providers in zip 00730 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275591489 | Roberto Gonzalez Gonzalez | Otolaryngology | Salud Ave. #1326, Suite 511, Ponce, PR 00717-1689 | 2006-05-04 |
| 1891104188 | Southwest Oto and Head & Neck Surgery,psc | Otolaryngology | Torre Med San Lucas, Ave. Tito Castro, Ponce, PR 00716-4728 | 2014-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568565547 | Recinto De Ciencias Medicas | Otolaryngology | Ave.americo Miranda Centro Medico De Pr Edif. Principal, Escuela De Medicina Aptdo.29134, San Juan, PR 00936-0134 | 2006-09-06 |
| 1902914807 | Benjamin Rodriguez Jr. | Otolaryngology | Manati Medical Plaza, Suite 205, Manati, PR 00674 | 2006-08-29 |
| 1508874876 | Jose I Almodovar - Laborde | Otolaryngology | Carr. 2 Km 174.0, San German Medical Plaza Suite 207, San German, PR 00683-9340 | 2006-08-03 |
| 1952300600 | Francisco R Suarez Lozada | Otolaryngology | 27 Calle Nelson Perea, Edificio Doctors Center Suite 102, Mayaguez, PR 00680-4949 | 2005-07-15 |
| 1740326677 | Grupo Otorrinolaringologico De Pr | Otolaryngology | Plaza Carolina Mall, Suite 11, Carolina, PR 00983 | 2007-01-29 |
| 1104987437 | Pablo M Lopez-baez | Otolaryngology | Santa Rosa Mall, 202a, Bayamon, PR 00959 | 2006-12-12 |
| 1952378341 | Jose R Sanchez-mendiola Sr. | Otolaryngology | Bayamon Medical Plaza, Suite 105, Bayamon, PR 00960 | 2006-03-03 |
| 1407820657 | Luis E Valledor Maeso Sr. | Otolaryngology | Bayamon Medical Plaza, Suite 105, Bayamon, PR 00960 | 2006-02-15 |
| 1003808171 | Jaime Luis Ortiz | Otolaryngology | Torre San Cristobal, 205 A, Coto Laurel, PR 00780 | 2005-08-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.