Basic Information
| Provider Information | |||||||||
| NPI: | 1770825317 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOMINGUEZ | ||||||||
| FirstName: | ROSARIO | ||||||||
| MiddleName: | EPE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6200 SW 73RD ST | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542765581 | ||||||||
| FaxNumber: | 9549857081 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 N 35TH AVE | ||||||||
| Address2: | SUITE 605 | ||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330215424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542657900 | ||||||||
| FaxNumber: | 9542760271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2013 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | ARNP2689032 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.