Individual ProviderTania Liz Rosario DominguezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9863 SW 184th St, Palmetto Bay, FL 33157-6934(305) 317-9592PECOS EnrollmentBased on the most recent information from CMS, provider Tania Liz Rosario Dominguez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1790345437Provider TypeIndividualFull NameRosario Dominguez, Tania LizCredentialNPGenderFemaleSole ProprietorYesEnumeration Date6/15/2019Last Updated2/17/2026Contact InformationPractice LocationPractice Address9863 SW 184th St, Palmetto Bay, FL 33157-6934Phone(305) 317-9592Fax(786) 431-2577Mailing LocationMailing Address9863 SW 184th St, Palmetto Bay, FL 33157-6934Phone(305) 317-9592Fax(786) 431-2577Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11002763Florida