Individual
ILEANA DOMINGUEZ BAUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3030 SW 96TH AVE, MIAMI, FL 33165-3039
(786) 419-0994
Mailing address
14707 SOUTH DIXIE HIGHWAY, PALMETTO BAY, FL, 33176, SUITE 201, PALMETTO BAY, FL 33176-3039
(786) 250-3475
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11006611
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11006611
FL
Other
Enumeration date
03/16/2020
Last updated
02/02/2024
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