LISA MARY DOMINACH

PORT CHARLOTTE, FL
NPI1811232515
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: FL  ARNP9360998)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: NJ  26NJ00408700)
Enumeration Date2012-12-06
Last Update Date2016-03-18
Business Address
-- LISA MARY DOMINACH ARNP
2335 AARON ST
PORT CHARLOTTE, FL 33952-5305
Phone number: 855-979-5700
Mailing Address
-- LISA MARY DOMINACH ARNP
3434 HANCOCK BRIDGE PKWY STE 301
NORTH FORT MYERS, FL 33904-7094
Phone number: 877-856-3774