Individual
ANGELICA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
595 W CHURCH ST APT 829, ORLANDO, FL 32805-7610
(689) 286-6163
Mailing address
1621 E VINE ST, KISSIMMEE, FL 34744-3730
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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