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NPI Code Detail

MEDICARE: MRS. DOMENIQUE VANESSA TRINGALI-HALLIBURTON PA-C

MEDICARE: MRS. DOMENIQUE VANESSA TRINGALI-HALLIBURTON PA-C
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601004530MI
2363A00000XPhysician Assistant9114212FL

General Provider Information

NPI Number : 1083882617
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DOMENIQUE VANESSA TRINGALI-HALLIBURTON PA-C
Provider Business Mailing Address
First Line : 1009 HOME GROVE DR
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-6532
Country : US
Telephone Number : 586-524-5565
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N ORANGE AVE STE 235
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4659
Country : US
Telephone Number : 407-821-3560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2008
Last Update Date : 04/06/2023

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Directions to “ MRS. DOMENIQUE VANESSA TRINGALI-HALLIBURTON PA-C” Practice Location

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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.

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