MEDICARE: DOMINIECE L COX

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
1	3747A0650X	Attendant Care Provider		FL

General Provider Information

NPI Number	:	1154908382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIECE L COX

Provider Business Mailing Address
First Line	:	13900 MADISON ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-6237
Country	:	US
Telephone Number	:	800-864-8718
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 PEACHTREE ST NE STE 100&200
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2177
Country	:	US
Telephone Number	:	800-864-8718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	07/11/2022

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