Kellie L Dominessy
TFPS IV LLC


Address: 2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417
Phone: 9547921010

Kellie L Dominessy (NPI# 1932403383, PAC ID# 1254512510) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.

Physician Overview

Nation Provider ID (NPI) 1932403383
PAC ID by PECOS 1254512510
Professional Enrollment ID I20110221000567
Full Name Kellie L Dominessy
Organization Legal Name TFPS IV LLC
Address 2307 W Broward Blvd
Suite 200
Ft Lauderdale
FL 33312-1417
Phone Number 9547921010
Gender F
Graduation Year 2010
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 0143526491
Number of Group Practice Members 6
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
100039 BROWARD HEALTH MEDICAL CENTER
100073 HOLY CROSS HOSPITAL
100029 NORTH SHORE MEDICAL CENTER

Other Locations

Address Phone Organization
2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417 9547921010 TFPS IV LLC
2307 W Broward Blvd, Ft Lauderdale, FL 33312-1417 9547921010 TFPS IV LLC

Organization Information

Organization Legal Name TFPS IV LLC
Physicians 3

Physicians with the same organization

Name Specialty Organization Address
Michael Adam Selepec Physician Assistant Tfps Iv LLC 2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417
George L Caldwell Sports Medicine Tfps Iv LLC 2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417

Office Location

Street Address 2307 W BROWARD BLVD
SUITE 200
City FT LAUDERDALE
State FL
Zip 33312-1417

Physicians in the same location

Name Specialty Organization Address
Michael Adam Selepec Physician Assistant Tfps Iv LLC 2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417
David A Padden Orthopedic Surgery Tenet Florida Physician Services LLC 2307 W Broward Blvd, Suite 200, Fort Lauderdale, FL 33312-1420
Michael C Kindya Orthopedic Surgery Tenet Florida Physician Services LLC 2307 W Broward Blvd, Suite 200, Fort Lauderdale, FL 33312-1420
George L Caldwell Sports Medicine Tfps Iv LLC 2307 W Broward Blvd, Suite 200, Ft Lauderdale, FL 33312-1417
Yaniret T. Carmenate Nurse Practitioner Tenet Florida Physician Services LLC 2307 W Broward Blvd, Suite 101, Ft Lauderdale, FL 33312-1417

Physicians in the same zip code

Name Specialty Organization Address
Charis-ann Ricketts Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Anna Z Hayden Family Medicine North Broward Hospital District 1101 W Broward Blvd, Fort Lauderdale, FL 33312-1638
Leon Nehmad Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Nadine Marie Yvanne Louissaint Nurse Practitioner North Broward Hospital District 1111 W Broward Blvd, Fort Lauderdale, FL 33312-1638
Perla G Najman Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Pooja Prasad Mahadev Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Julie A Tyler Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Alexandra Espejo Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Katherine Elizabeth Green Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Reena Patel Optometry Nova Southeastern University, Inc 1111 W Broward Blvd, Eye Institute, Ft Lauderdale, FL 33312-1638
Find all physicians in zip 33312

Competitor

Search similar physicians

City FT LAUDERDALE
Zip Code 33312
Specialty PHYSICIAN ASSISTANT
City + Specialty FT LAUDERDALE + PHYSICIAN ASSISTANT

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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