Provider Demographics
NPI:1437652799
Name:DOMINGUEZ, AKEMY S (MSN, ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:AKEMY
Middle Name:S
Last Name:DOMINGUEZ
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15551 SW 155TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-0710
Mailing Address - Country:US
Mailing Address - Phone:786-333-5345
Mailing Address - Fax:
Practice Address - Street 1:135 SAN LORENZO AVE STE 550
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1880
Practice Address - Country:US
Practice Address - Phone:305-665-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9302161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily