Dominguez, Lissette Maria

Dominguez, Lissette Maria is an individual health care provider with primary practice located at 2625 Tamiami Trl Suite 5, Port Charlotte FL 33952-6403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Dominguez, Lissette Maria can be contacted via phone (941) 764-7999.

Contact Information

Primary practice address
2625 Tamiami Trl Suite 5 Port Charlotte FL 33952-6403
Phone: (941) 764-7999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP9248661 Florida

Profile Details

NPI number 1770888141
LBN Legal business name Dominguez, Lissette Maria
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2011
Last updated Jan 17th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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