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Search › Florida › 1041C0700X

Dominique Bullock

NPI 1396698726 · on the registry since 2026 · sole proprietor

Practice

Address
22790 Sw 112th Ave
Miami, FL 33170
Phone
(305) 609-1470
Organisation at this address
Genoa Healthcare Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
139

Additional practice sites

  • 23419 Sw 127th Pl, Homestead, FL

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-05-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida