Provider Demographics
NPI:1730051129
Name:DOMINGUEZ, ANGEL (MUSIC THERAPIST)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:DOMINGUEZ
Suffix:
Gender:M
Credentials:MUSIC THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 SW 134TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4369
Mailing Address - Country:US
Mailing Address - Phone:305-781-8051
Mailing Address - Fax:
Practice Address - Street 1:7500 NW 25TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1721
Practice Address - Country:US
Practice Address - Phone:305-909-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty