Individual provider · Type 1 NPI

Emmanuel Carlo Mantes Dominguez, MD

Student in an Organized Health Care Education/Training Program · Fort Walton Beach, FL

NPI number 1487413704 Active

Practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Call (850) 969-4500 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1487413704

Emmanuel Carlo Mantes Dominguez, MD's National Provider Identifier is 1487413704, issued on Mar 18, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Mar 18, 2024.