Individual
ANEESAH DENISE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15417 SHOAL HAVEN PL, RUSKIN, FL 33573-0101
(813) 360-1545
Mailing address
15417 SHOAL HAVEN PL, RUSKIN, FL 33573-0101
(813) 360-1545
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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