Healthcare Provider Details

I. General information

NPI: 1447875299
Provider Name (Legal Business Name): CLAUDIA DOMINGUEZ RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 HANCOCK BRIDGE PKWY
CAPE CORAL FL
33990-1715
US

IV. Provider business mailing address

1413 SW 18TH ST
CAPE CORAL FL
33991-3222
US

V. Phone/Fax

Practice location:
  • Phone: 239-834-8018
  • Fax:
Mailing address:
  • Phone: 239-834-8018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13563
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT20118267
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: