Jessica Adams-Dominguez, DPT
Individual provider Active NPI Specialist · Doral, FL
NPI 1609154236 · NPPES record last updated Aug 1, 2011
Key facts
- NPI
- 1609154236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- PT25131 (FL)
- Practice address
- 2600 NW 87TH Ave
Ste 22
Doral, FL 33172-1621 - Phone
- (305) 592-5555
- Fax
- (305) 592-6067
- NPI assigned
- Aug 1, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT25131 | FL | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT25131 | FL | Yes |
Addresses
Primary practice location
2600 NW 87TH Ave
Ste 22
Doral, FL 33172-1621
Mailing address
2600 NW 87TH Ave
Ste 22
Doral, FL 33172-1621
Phone (305) 592-5555
Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.