Individual
DINO RAUL DOMINGUEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6076
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN3150502
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0564
AZ
367500000X
Certified Registered Nurse Anesthetist
R168347
MD
Other
Enumeration date
12/05/2005
Last updated
03/16/2026
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