Individual
DOMINGO LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2140 W 68TH ST STE 200, HIALEAH, FL 33016-1815
(305) 822-7227
Mailing address
6321 SW 156TH CT, MIAMI, FL 33193-2801
(786) 768-0290
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9251444
FL
Other
Enumeration date
12/18/2009
Last updated
04/08/2016
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