Individual
MS. MARIE KETLIE DOMINIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3260 JASPER WAY, MIRAMAR, FL 33025-4246
(954) 338-8117
Mailing address
3260 JASPER WAY, MIRAMAR, FL 33025-4246
(954) 338-8117
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
RT9200
FL
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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