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General NPI Number Information
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NPI Number | 1033754635
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Entity Type | Individual
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Provider Name | DIUSNAIDY DOMINGUEZ HERNANDEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 7027 W 6TH AVE
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City | HIALEAH
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State | FL
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Zip | 33014-4935
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Country | US
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Telephone | 786-356-0179
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Fax |
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Provider Business Mailing Address
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Address Line | 7027 W 6TH AVE
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City | HIALEAH
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State | FL
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Zip | 33014-4935
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Country | US
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Telephone | 786-356-0179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP11004849
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License Number State | FL
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