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General NPI Number Information
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NPI Number | 1902948086
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH DOMINGO FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 10409 ANGEL OAK CT
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City | ORLANDO
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State | FL
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Zip | 32836-6513
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Country | US
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Telephone | 407-536-9751
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Fax | 424-484-2667
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Provider Business Mailing Address
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Address Line | 8 THE GRN
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City | DOVER
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State | DE
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Zip | 19901-3618
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Country | US
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Telephone | 407-536-9751
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Fax | 424-484-2667
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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 | F332209-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC005113
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 72269
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11015101
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License Number State | FL
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