Healthcare Provider Details

I. General information

NPI: 1598887655
Provider Name (Legal Business Name): FRANCISCO JOSE DOMINICCI CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 NW 186TH ST APT.412
HIALEAH FL
33015-3308
US

IV. Provider business mailing address

6700 NW 186TH ST APT.412
HIALEAH FL
33015-3308
US

V. Phone/Fax

Practice location:
  • Phone: 786-340-4136
  • Fax:
Mailing address:
  • Phone: 786-340-4136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License NumberTT 13235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: