Individual
MICHELLE ASHLEY DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1573 W FAIRBANKS AVE STE 100, WINTER PARK, FL 32789-4679
(407) 896-8097
Mailing address
393 COPPERSTONE CIR, CASSELBERRY, FL 32707-5861
(407) 312-3905
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11029394
FL
Other
Enumeration date
11/07/2023
Last updated
05/09/2024
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