Elides Dominguez, CACII
General Practice in Wesley Chapel, FL. Individual provider (NPI-1).
NPI number1124475835
StatusActive
Last updated in NPPESAug 11, 2022
Details
- NPI
- 1124475835
- Entity type
- Individual (NPI-1)
- Name
- Elides Dominguez
- Credential
- CACII
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 23, 2016
- Certification date
- Aug 11, 2022
- Last updated
- Aug 11, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - GENERAL PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | ACN1111 | FL | Yes |
Practice location
2607 Windguard Cir Ste 102Wesley Chapel, FL 33544-7352
Phone 813-907-6767 · Fax 813-907-1911
Mailing address
5626 Curry Ford RdOrlando, FL 32822-1424
Phone 407-985-5677 · Fax 844-388-6186
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 General Practice Physician providers in Wesley Chapel · All 2,637 providers in Wesley Chapel
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