Individual provider Active NPI

Dominiqua Alexis, APRN

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1053882290
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9301470 Issued in FL
Practice address
9975 Tavistock Lakes Blvd Ste 220
Orlando, FL 32827-7665
Phone
(407) 930-7801
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9301470 FL Primary

Addresses

Primary practice location

9975 Tavistock Lakes Blvd Ste 220
Orlando, FL 32827-7665

Mailing address

9975 Tavistock Lakes Blvd Ste 220
Orlando, FL 32827-7665
Phone (407) 930-7801

Other practice location 1

1514 1st St N
Winter Haven, FL 33881-2476
Phone (863) 292-4280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190110000819 FL Practitioner - Nurse Practitioner 2264778349 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc CurrentSince Jan 7, 2019 Accepting new patients
Adventhealth Primary Care Network Inc Family CurrentSince Jan 1, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 25, 2023 Accepting new patients
Central Florida Health Care Inc CurrentSince Jan 7, 2019 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 25, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Lake Wales, FL 33853
Phone (863) 678-4144

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

9975 Tavistock Lakes Blvd
Ste 220
Orlando, FL 32827
Phone (407) 930-7800

1514 1st St N
Winter Haven, FL 33881
Phone (863) 291-5110

47 5th St NW
Winter Haven, FL 33881

Interoperability endpoints

  • Direct secure messaging: dlint1669031@adventhealth.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1053882290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9975 TAVISTOCK LAKES BLVD STE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277665",
            "telephone_number": "407-930-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 TAVISTOCK LAKES BLVD STE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277665",
            "telephone_number": "407-930-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 1st St N",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338812476",
            "country_code": "US",
            "telephone_number": "863-292-4280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "DOMINIQUA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9301470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.