DR. OMAR DEAN HUDSON (NPI# 1043417421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043417421 |
| Entity Type | Individual |
| Full Name | DR. OMAR DEAN HUDSON |
| Credential | M.D. |
| Practice Address |
1223 Gateway Dr Ste 1g Melbourne FL 32901-2607 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3217230072 |
| Practice Fax Number | 3219520850 |
| Mailing Telephone | 3217230072 |
| Mailing Fax Number | 3219517408 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
ME103869 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 29192 | 01 |
| FL | AETNA | 9796123 | 01 |
| FL | MEDICARE | CQ236Y | 01 |
| FL | 000990300 | 05 |
| Street Address |
1223 GATEWAY DR STE 1G |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811987985 | John A Duncan | Pediatrics | 1223 Gateway Dr, 1g, Melbourne, FL 32901-2607 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891359998 | Kids and Families Medical Clinic LLC | Pediatrics | 12086 Fort Caroline Rd Ste 404, Jacksonville, FL 32225-7640 | 2019-04-24 |
| 1942438767 | Lisa Erin Kenigsberg Fechter | Pediatrics | 9600 W Sample Rd Ste 505, Coral Springs, FL 33065-4037 | 2009-07-01 |
| 1063671212 | Miladys Miriam Palau Collazo | Pediatrics | 9401 Sw Discovery Way Ste 102, Port Saint Lucie, FL 34987-2381 | 2008-06-03 |
| 1790987964 | Konda Mohan Reddy | Pediatrics | 1801 Lee Rd Ste 170, Winter Park, FL 32789 | 2007-06-01 |
| 1477764207 | Sissi Cossio | Pediatrics | 7605 N State Rd 7, Parkland, FL 33067 | 2007-05-24 |
| 1588701379 | Samuel M Freedman | Pediatrics | 601 N Flamingo Rd Ste 207, Pembroke Pines, FL 33028-1009 | 2007-01-31 |
| 1326116443 | Kelly J Seiler | Pediatrics | 10383 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3782 | 2006-11-30 |
| 1447324744 | Luis E Gonzalez-mendoza | Pediatrics | 3100 Sw 62nd Ave Ste 122, Miami, FL 33155-3009 | 2006-11-20 |
| 1538240320 | Amid Habib | Pediatrics | 789 Douglas Ave, Suite 137, Altamonte Springs, FL 32714 | 2006-10-18 |
| 1376652131 | Mauri Carakushansky | Pediatrics | 115 Columbia St, Suite B, Orlando, FL 32806-1046 | 2006-08-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.