MR. BRISTOL DOMINGUEZ (NPI# 1255578761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255578761 |
| Entity Type | Individual |
| Full Name | MR. BRISTOL DOMINGUEZ |
| Credential | CSA |
| Practice Address |
717 Mcintosh St West Palm Beach FL 33405-3145 |
| Practice Telephone | 5617796367 |
| Practice Fax Number | 5615862275 |
| Mailing Telephone | 5617796367 |
| Mailing Fax Number | 5615862275 |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2009-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
717 MCINTOSH ST |
| City | WEST PALM BEACH |
| State | FL |
| Zip Code | 33405-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316460033 | Luis Rafael Victoria | Behavior Technician | 521 Hunter St, Apt 1, West Palm Beach, FL 33405 | 2017-07-25 |
| 1942740865 | Monica Danielle Walling | Counselor | 6107 S Dixie Hwy Ste 3, West Palm Beach, FL 33405 | 2017-02-24 |
| 1609324912 | Prime Physicians Group | Nurse Practitioner | 6600 S. Dixie Hwy, West Palm Beach, FL 33405 | 2016-09-15 |
| 1124499827 | Victoria Cunnea | Chiropractor | 605 Belvedere Rd Ste 18, West Palm Beach, FL 33405 | 2015-10-07 |
| 1902216963 | Stephanie Cheshire | Social Worker | 221 Westminster Road, West Palm Beach, FL 33405 | 2014-04-30 |
| 1245577899 | Iliana Esther Falero | Pharmacist | 828 Suthern Blvd, West Palm Beach, FL 33405 | 2013-01-15 |
| 1073894630 | Renee Lynn Rattray | Counselor | 217.5 Greenwood Drive, West Palm Beach, FL 33405 | 2011-09-08 |
| 1578851507 | Townley Peters | Psychologist | 227 Elwa Pl, West Palm Beach, FL 33405 | 2011-07-11 |
| 1679891667 | Lynda Jennifer Pardo | Pharmacist | 838 Southern Blvd, Publix Pharmacy, West Palm Beach, FL 33405 | 2010-05-14 |
| 1013167170 | Louis Theodore Joseph | Psychiatry & Neurology | 302 E Lakewood Rd, West Palm Beach, FL 33405 | 2008-09-25 |
| Find all providers in zip 33405 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326512617 | Fleura Cenatus | Physician Assistant | 1917 N Haverhill Rd Apt 1, West Palm Beach, FL 33417-4692 | 2019-01-19 |
| 1437635943 | Shanna Bhagan | Physician Assistant | 4500 N Flagler Dr Apt B16, West Palm Beach, FL 33407 | 2018-07-17 |
| 1073009353 | Kaitlyn Rose Green | Physician Assistant | 560 Village Blvd Suite #150, West Palm Beach, FL 33409 | 2018-07-10 |
| 1780187716 | Punam Gopal | Physician Assistant | 3507 Broadway, West Palm Beach, FL 33407-4841 | 2018-03-15 |
| 1932555323 | Zoilemma Acosta | Physician Assistant | 4232 Colt Ln, West Palm Beach, FL 33406-2936 | 2016-05-04 |
| 1528436649 | Farah Alli | Physician Assistant | 2007 Palm Bch Lk Blvd, West Palm Beach, FL 33409-6501 | 2015-09-05 |
| 1811238272 | Gioconda Alicia Boaz | Physician Assistant | 2685 Forest Hill Blvd, West Palm Beach, FL 33406-5930 | 2013-03-11 |
| 1932452158 | Joseph Radich | Physician Assistant | 1411 N Flagler Dr Ste 9000, West Palm Beach, FL 33401-3421 | 2012-10-25 |
| 1023380599 | Neesha R Patel | Physician Assistant | 2047 Palm Beach Lakes Blvd Ste 300, West Palm Beach, FL 33409-6500 | 2012-01-31 |
| 1093858771 | Bradley Scott Burdette I | Physician Assistant | 7240 7th Pl N, West Palm Beach, FL 33411-3801 | 2007-02-14 |
| Find all providers in WEST PALM BEACH | ||||
| City | WEST PALM BEACH |
| Zip Code | 33405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.