Provider Demographics
NPI:1255670550
Name:DOMINIQUE, CYNTHIA ALCEUS (ARNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ALCEUS
Last Name:DOMINIQUE
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:ALCEUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, FNP-C
Mailing Address - Street 1:100 E SAMPLE RD
Mailing Address - Street 2:UNIT 330
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3554
Mailing Address - Country:US
Mailing Address - Phone:954-461-7469
Mailing Address - Fax:
Practice Address - Street 1:100 E SAMPLE RD
Practice Address - Street 2:UNIT 330
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3554
Practice Address - Country:US
Practice Address - Phone:954-461-7469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295444363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health