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
Mailing address1720 S Orange Ave Ste 500, Orlando, FL 32806-2967

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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