MR. NEILROSE LACISTE GERVACIO


Address: Camp Schwab Bmc, 3d Med Bn, 3d Mlg, C Co, Fpo, AP 96604
Phone: 011816117252272

MR. NEILROSE LACISTE GERVACIO (NPI# 1063460210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063460210
Entity Type Individual
Full Name MR. NEILROSE LACISTE GERVACIO
Credential IDC
Practice Address Camp Schwab Bmc
3d Med Bn, 3d Mlg, C Co
Fpo
AP 96604
Mailing Address Psc 557 Box 2631
Fpo
AP 96379
Practice Telephone 011816117252272
Enumeration Date 2006-05-04
Last Update Date 2008-04-20
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
INDEPENDENT DUTY CORPSMAN 1710I1002X 01

Office Location

Street Address CAMP SCHWAB BMC
3D MED BN, 3D MLG, C CO
City FPO
State AP
Zip Code 96604

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114254448 Hector Joel Silva Military Health Care Provider 3med Bn 3mlg H&s Co. Unit 38447, Fpo, AP 96604 2009-11-06
1922203611 Lorenzo F Basilio IIi Military Health Care Provider 3d Medical Bn, Bravo Company, Camp Hansen, OKINAWA 96604 2007-06-20
1508061292 Jeremy S Covell Military Health Care Provider 3rd Med Bn 3rd Fssg, Bravo Co Unit 38448, Fpo, AP 96604 2007-06-20
1629132501 Michael Adam Ravens Dentist 3d Dental Battalion, Unit 38450, Fpo, AP 96604 2006-12-21
1669535936 Faron Michael Uebelacker Military Health Care Provider 3d Med Bn 3d Mlg, Unit 38449, Fpo, AP 96604 2006-12-18
1659474229 Rachel Miyoko Anderson Dentist 3d Denbn/usndc, Unit 38450, Fpo, AP 96604 2006-09-07
1093795247 Douglas Scott Trenor Dentist 3d Den Bn/usndc, 3mlg, Detc, Unit 88452, Fpo, AP 96604 2006-01-21
1346529559 Ujval Reddy Gummi Dentist 3d Dental Battalion/usndc Okinawa, Unit 38450, Fpo, AP 96604 2011-08-05
1962492447 Jeffrey Nils Korsnes Dentist 3d Dental Battalion/us Naval Dental Denter, 3d Mlg, Camp Hansen, Unit 38452, Fpo, AP 96604-0259 2005-10-25
1992251763 Jackson Dehn Military Health Care Provider 3rd Marine Logistics Group, Unit 38404, Fpo, AP 96604-8404 2016-08-31
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538768833 James Blake Weldon Military Health Care Provider Unit 100517 Bx 1, Fpo, AP 09655 2020-10-19
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1396370623 Daniel Rocha Moy Military Health Care Provider Uss Thunderbolt (pc-12), Fpo, AE 09588 2020-03-06
1639701634 Stephen Henderson Military Health Care Provider 3d Recon Bn, Force Co., Unit 36180, Fpo, AP 96389-6180 2020-02-07
1649810219 Maxwell Onyedikachi Osisioma Military Health Care Provider Psd-18, Macg-18, 1st Maw Unit 37172, Fpo, AP 96372 2020-01-13
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1053955609 Christopher Zartman Military Health Care Provider Camp Foster, Okinawa Japan, Fpo, AP 96379-0005 2019-11-06
1912553975 Brandon Joseph Dapper Military Health Care Provider Camp Lejeune, Nc, 2d Reconnaissance Battalion Battalion Aid Station, Fpo, AA 28542-0138 2019-08-15
1518525583 William Edward Mcbreen Jr. Military Health Care Provider Coastal Riverine Group 1 Detachment Guam, Fpo, AP 96540-1400 2019-06-04
1558832345 Nathaniel Franklin Campbell Military Health Care Provider Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 2018-12-06
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Competitor

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City FPO
Zip Code 96604

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Dataset Information

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.

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