Provider Demographics
NPI:1407642408
Name:RODRIGUEZ DOMINGEZ, MARIKARLA
Entity type:Individual
Prefix:
First Name:MARIKARLA
Middle Name:
Last Name:RODRIGUEZ DOMINGEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 NE 8TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-4460
Mailing Address - Country:US
Mailing Address - Phone:239-770-5449
Mailing Address - Fax:
Practice Address - Street 1:2124 NE 8TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-4460
Practice Address - Country:US
Practice Address - Phone:239-770-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1252623374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty