Individual
DOMINIQUE REGISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3207 TRADEWINDS TRL, ORLANDO, FL 32805-5851
(321) 239-7606
Mailing address
3207 TRADEWINDS TRL, ORLANDO, FL 32805-5851
(321) 239-7606
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9203116
FL
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024196800
—
FL
Enumeration date
02/07/2019
Last updated
02/07/2019
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