Individual
MRS. JOHANNE RICHARD DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
7900 NW 27TH AVE STE 50, MIAMI, FL 33147-4909
(305) 758-0591
Mailing address
1441 SW 97TH AVE, PEMBROKE PINES, FL 33025-3685
(786) 210-3515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11005018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105483200
—
FL
Enumeration date
11/17/2019
Last updated
09/23/2022
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