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

Theresa M Domagola, ACNP-BC, PMHNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1184676322

Theresa M Domagola, ACNP-BC, PMHNP-BC is a Nurse Practitioner in Jacksonville, Florida. Graduated from University of Rochester School of Medicine and Dentistry in 2003, 23 years ago. Practices with University of Florida Jacksonville Physicians, Inc, a 903-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and New York.

Years since qualifying
23
Trained at
University of Rochester School of Medicine and Dentistry
Licensed in
FL, NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

15255 Max Leggett Pkwy Ste 3600
Jacksonville, FL 32218-7279
Phone: (904) 427-6895
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 11002747 (FL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 430210 (NY)

Record details

NPI number1184676322
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP-BC , PMHNP-BC
Sole proprietorNo
NPI enumeratedMay 16, 2006
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduated 2003 (23 years in practice)
Group practice University Of Florida Jacksonville Physicians, Inc. — 903 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Jacksonville