Angelo S Domingo Jr LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY7379 Issued in FL

Legal business name

ANGELO S DOMINGO JR LLC

Practice address

9926 52ND St E
Parrish, FL 34219-4417

Phone

(203) 668-6318

NPI assigned

Apr 14, 2009

Last updated

Apr 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angelo S Domingo Jr., PSYDNPI 1003951344

Title

Managing Member

Phone

(203) 668-6318

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelo Sebastian Domingo, PSY.D

  • Clinical Psychologist
  • Parrish, FL
  • NPI 1003951344
  Authorized official Same address or phone

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1285877795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9926 52ND ST E",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342194417",
            "telephone_number": "203-668-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9926 52ND ST E",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342194417",
            "telephone_number": "203-668-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELO S DOMINGO JR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "DOMINGO",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "203-668-6318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Parrish, FL
• Providers in Parrish, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.