Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Dominguez

Individual provider Surgical Physician Assistant · NPI 1679458137

Michelle Dominguez is a Physician Assistant in Orlando, Florida. Qualified in 2025, 1 year ago. Works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
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Practice location Address checks out

1720 S Orange Ave Ste 500
Orlando, FL 32806-2967
Phone: (407) 540-1616
Fax: (407) 540-1094
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4850 Millenia Blvd, Orlando, FL 32839-6012 — (407) 264-5601

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9120952 (FL)

Record details

NPI number1679458137
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 6, 2025
Last updated in NPPESJanuary 28, 2026
Certification dateJanuary 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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