Individual
WALTER DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
860 W 36TH ST, HIALEAH, FL 33012-5164
(786) 482-0576
Mailing address
860 W 36TH ST, HIALEAH, FL 33012-5164
(786) 482-0576
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
Primary
SI6238
FL
Other
Enumeration date
01/19/2017
Last updated
12/15/2025
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