MEDICARE: CAROLINA DOMINGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	222Q00000X	Developmental Therapist
3	252Y00000X	Early Intervention Provider Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821486804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA DOMINGUEZ

Provider Business Mailing Address
First Line	:	1708 WALDEN LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5631
Country	:	US
Telephone Number	:	703-342-2346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1708 WALDEN LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5631
Country	:	US
Telephone Number	:	703-342-2346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	01/26/2021

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1417833302 — NOVA SENIOR CARE, INC
Practice Location Address:

1708 WALDEN LN
WEST PALM BEACH, FL
33406-5631

Practice Phone: 561-541-1914
Practice Fax:

1598081416 — DR. JENNIFER LEE GUTHRIE M.D.
Practice Location Address:

224 DATURA ST STE 315
WEST PALM BEACH, FL
33401-5631

Practice Phone: 561-214-3323
Practice Fax: 561-828-6247

1821505215 — GROTTO MEDCLUB LLC
Practice Location Address:

224 DATURA ST STE 315
WEST PALM BEACH, FL
33401-5631

Practice Phone: 561-214-3323
Practice Fax:

1023649340 — VJERA ZEC
Practice Location Address:

224 DATURA ST STE 315
WEST PALM BEACH, FL
33401-5631

Practice Phone: 201-591-5498
Practice Fax:

1457979775 — SUPPORTIVE SUPPLIES LLC
Practice Location Address:

224 DATURA ST STE 307
WEST PALM BEACH, FL
33401-5631

Practice Phone: 800-233-4950
Practice Fax:

Directions to “ CAROLINA DOMINGUEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.