Provider Demographics
NPI:1770825317
Name:DOMINGUEZ, ROSARIO EPE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:EPE
Last Name:DOMINGUEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SW 73RD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4679
Mailing Address - Country:US
Mailing Address - Phone:954-276-5581
Mailing Address - Fax:954-985-7081
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-7900
Practice Address - Fax:954-276-0271
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2689032363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care