Individual
CHRISTOPHER OMAR DOMINGUEZ CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 UTRILLO PL, PALM COAST, FL 32164-5901
(386) 347-9873
Mailing address
24 UTRILLO PL, PALM COAST, FL 32164-5901
(386) 347-9873
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9608065
FL
363LF0000X
Family Nurse Practitioner
Primary
11046877
FL
Other
Enumeration date
04/09/2026
Last updated
04/16/2026
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