Individual provider Active NPI

Marlevy Dominguez, APRN

  • Family Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1700752599
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11042914 Issued in FL
Practice address
672 SW Prima Vista Blvd Ste 102
Port St Lucie, FL 34983-1820
Phone
(772) 905-2560
Fax
(772) 336-8341
NPI assigned
Oct 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11042914 FL Primary

Addresses

Primary practice location

672 SW Prima Vista Blvd Ste 102
Port St Lucie, FL 34983-1820

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (772) 905-2560

Other practice location 1

9109 S US Highway 1 Ste 102
Port St Lucie, FL 34952-3453
Phone (772) 253-1642

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
I20251215002559 FL Practitioner - Nurse Practitioner 9133613318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Xpress Urgent Care LLCGroup PAC ID 0042454944, 31 clinicians

Practice addresses (Care Compare)

672 SW Prima Vista Blvd
Suite 102
Port Saint Lucie, FL 34983-1820
Phone (772) 905-2560

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11042914FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Xpress Urgent Care, LLC. Single Specialty CurrentSince Dec 9, 2025 Accepting new patients
Medical Consultants of Florida, LLC Single Specialty Current Accepting new patients
M and S Medical Services, Corp Current Accepting new patients
MD Family & Wellness, Corp CurrentSince Nov 30, 2025 Accepting new patients

Locations

672 SW Prima Vista Blvd
#10
Port St Lucie, FL 34983
Phone (772) 905-2555

9109 S US Highway 1
Ste 102
Port St Lucie, FL 34952
Phone (772) 253-1642

672 SW Prima Vista Blvd
Ste 102
Port St Lucie, FL 34983
Phone (772) 905-2555

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1700752599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "772-905-2560",
            "fax_number": "772-336-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 SW PRIMA VISTA BLVD STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831820",
            "telephone_number": "772-905-2560",
            "fax_number": "772-336-8341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9109 S US Highway 1 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349523453",
            "country_code": "US",
            "telephone_number": "772-253-1642",
            "fax_number": "772-253-1643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MARLEVY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11042914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.