Individual
MS. MARITZA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2980 PARK POND WAY, KISSIMMEE, FL 34741
(407) 930-4711
(866) 255-1576
Mailing address
2980 PARK POND WAY, KISSIMMEE, FL 34741
(407) 930-4711
(866) 255-1576
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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