OrganizationDomahn, IncSpecialistOther Service ProvidersPractice Address3109 Tamiami Trl, Port Charlotte, FL 33952-8046(941) 235-1500PECOS EnrollmentBased on the most recent information from CMS, provider Domahn, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:30 PM.Profile DetailsProvider ID1982858049Provider TypeOrganizationFull NameDomahn, IncSubpartNoEnumeration Date11/15/2008Last Updated11/15/2008Contact InformationPractice LocationPractice Address3109 Tamiami Trl, Port Charlotte, FL 33952-8046Phone(941) 235-1500Fax(941) 235-1508Mailing LocationMailing Address3109 Tamiami Trl, Port Charlotte, FL 33952-8046Phone(941) 235-1500Fax(941) 235-1508Authorized OfficialNameAmilcar, Mitho Larose (Adminstrator)Phone(941) 235-1500Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseMA34283Florida