# ANGELO S DOMINGO JR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285877795
- **Authorized official:** DR. ANGELO S DOMINGO JR. PSYD (MANAGING MEMBER)
- **Authorized official phone:** (203) 668-6318

## Contact information

- **Practice address:** 9926 52ND ST E, PARRISH, FL 34219-4417
- **Practice address phone:** (203) 668-6318
- **Mailing address:** 9926 52ND ST E, PARRISH, FL 34219-4417
- **Mailing address phone:** (203) 668-6318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PY7379 | FL | Yes |

## Other

- **Enumeration date:** 04/14/2009
- **Last updated:** 04/14/2009