Individual
SHELLA DOMINIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1499 FOREST HILL BLVD STE 117, WEST PALM BEACH, FL 33406-6050
(786) 263-8450
(561) 536-7011
Mailing address
1145 VERMILION DR, LAKE WORTH, FL 33461-3328
(561) 448-5287
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
30212208
FL
Other
Enumeration date
03/02/2022
Last updated
06/21/2023
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