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NPI Code Detail

MEDICARE: KAREN FRANCISCO DOMANSKI RPT

MEDICARE: KAREN FRANCISCO DOMANSKI RPT
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
1225100000XPhysical Therapist070015544IL

General Provider Information

NPI Number : 1114102977
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN FRANCISCO DOMANSKI RPT
Provider Business Mailing Address
First Line : 1290 SW BRIARWOOD DR
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34986-2333
Country : US
Telephone Number : 309-333-5679
Fax Number :
Provider Business Practice Location Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number : 772-465-7560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2007
Last Update Date : 03/18/2021

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