Provider Demographics
NPI:1598887655
Name:DOMINICCI, FRANCISCO JOSE (CRT)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JOSE
Last Name:DOMINICCI
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 NW 186TH ST
Mailing Address - Street 2:APT.412
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3308
Mailing Address - Country:US
Mailing Address - Phone:786-340-4136
Mailing Address - Fax:
Practice Address - Street 1:6700 NW 186TH ST
Practice Address - Street 2:APT.412
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3308
Practice Address - Country:US
Practice Address - Phone:786-340-4136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT 132352278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care