Individual provider Active NPI

Domenique Vanessa Tringali-Halliburton, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1083882617
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114212 Issued in FL
Practice address
2501 N Orange Ave Ste 411
Orlando, FL 32804-4644
Phone
(407) 303-7298
Fax
(407) 303-2886
NPI assigned
Feb 17, 2008
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004530 MI
Physician Assistant 363A00000X PA9114212 FL Primary

Addresses

Primary practice location

2501 N Orange Ave Ste 411
Orlando, FL 32804-4644

Mailing address

1009 Home Grove Dr
Winter Garden, FL 34787-6532
Phone (586) 524-5565

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
I20230410001364 FL Practitioner - Physician Assistant 7315013414 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9114212FLMDPhysician Assistant
5601004530MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Feb 13, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 13, 2023 Accepting new patients

Locations

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

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

Interoperability endpoints

  • Direct secure messaging: dtringalihalliburton1146466@adventhealth.direct-ci.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1083882617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 HOME GROVE DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876532",
            "telephone_number": "586-524-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 411",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644",
            "telephone_number": "407-303-7298",
            "fax_number": "407-303-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINGALI-HALLIBURTON",
        "first_name": "DOMENIQUE",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-17",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004530",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.