Provider Demographics
NPI:1902948086
Name:DOMINGO, BENJAMIN JOSEPH (FNP-C)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JOSEPH
Last Name:DOMINGO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
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Mailing Address - Street 1:8 THE GRN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:407-536-9751
Mailing Address - Fax:424-484-2667
Practice Address - Street 1:10409 ANGEL OAK CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-6513
Practice Address - Country:US
Practice Address - Phone:407-536-9751
Practice Address - Fax:424-484-2667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF332209-1363LF0000X
MDAC005113363LF0000X
ID72269363LF0000X
FLAPRN11015101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily