Individual
DOMENIQUE MASSARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
460 N STATE ROAD 7 STE 300, ROYAL PALM BEACH, FL 33411-3514
(561) 798-6600
(561) 753-3328
Mailing address
10131 FOREST HILL BLVD STE 230, WELLINGTON, FL 33414-6109
(561) 798-6600
(561) 615-1958
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9106282
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9106282
FL
Other
Enumeration date
04/19/2012
Last updated
10/23/2012
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