OMAR ANTONIO PESCADOR (NPI# 1720352958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720352958 |
Entity Type | Individual |
Full Name | OMAR ANTONIO PESCADOR |
Credential | IDC |
Practice Address |
Seal Team 10 Medical Department Bldg 3808 Virginia Beach VA 23521 |
Mailing Address |
7568 Roaring Springs Rd Gloucester VA 23061-4269 |
Practice Telephone | 9178483454 |
Mailing Telephone | 9178483454 |
Enumeration Date | 2012-03-06 |
Last Update Date | 2012-03-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
Street Address |
SEAL TEAM 10 MEDICAL DEPARTMENT BLDG 3808 |
City | VIRGINIA BEACH |
State | VA |
Zip Code | 23521 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013219591 | Naval Special Warfare Group Three Det Little Creek | Military Hospital | 1840 Intercove Rd, Norfolk, VA 23521 | 2010-12-03 |
1750610788 | Melissa Christine Foster | Military Health Care Provider | 2901 Amphibious Drive, Acu-2, Norfolk, VA 23521 | 2009-12-22 |
1396837068 | Sharon A Raghubar | Dentist | Nab Little Creek, 1035 Nider Blvd. Suite 200, Norfolk, VA 23521 | 2006-09-29 |
1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
1518937846 | Timothy Paul Tobin | Optometrist | Branch Medical Clinic, Little Creek, 1035 Nider Blvd Ste 100, Norfolk, VA 23521 | 2006-01-26 |
1225273691 | Jason Paul Arceneaux | Military Health Care Provider | 1355 Helicopter Rd, Norfolk, VA 23521 | 2008-12-12 |
1679749220 | Christopher J Marquez | Military Health Care Provider | 1840 Gator Blvd, Seal Team Two Bldg 3841, Norfolk, VA 23521 | 2008-05-05 |
1073513099 | Thomas Schlater | Optometrist | 1035 Nider Blvd, Norfolk, VA 23521 | 2005-08-01 |
1902066731 | Scott Lafountaine | Military Health Care Provider | 1840 Cove Road, Naval Special Warfare Group Two Medical Department, Norfolk, VA 23521-2100 | 2008-06-16 |
1205018819 | Keith Staples | Military Health Care Provider | 1310 8th St, Suite 100, Norfolk, VA 23521-2416 | 2007-12-05 |
Find all providers in zip 23521 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306455522 | Kevin Bradley | Military Health Care Provider | 903 13th St, Virginia Beach, VA 23451-4476 | 2020-07-23 |
1851900088 | Seth Walter | Military Health Care Provider | 1825 Olympic Dr, Virginia Beach, VA 23453-3720 | 2020-07-23 |
1912545534 | Ashton Neal Burnett | Military Health Care Provider | 1875 Cove Rd Bldg 3806, Virginia Beach, VA 23459-8911 | 2019-12-13 |
1578056743 | Elis Bojaxhi | Military Health Care Provider | 3044 Ashlawn Ter, Virginia Beach, VA 23452-6508 | 2018-06-12 |
1497298616 | Mario Zavala | Military Health Care Provider | 408 N Amsterdam Ct, Virginia Beach, VA 23454-4213 | 2016-11-19 |
1568904738 | Pierce Cogburn | Military Health Care Provider | 3985 Old Forge Rd, Virginia Beach, VA 23452-2173 | 2016-11-04 |
1851841449 | John Douglas Moore | Military Health Care Provider | 1004 Hermitage Rd Bldg 1014, Virginia Beach, VA 23459-9100 | 2016-10-07 |
1730559618 | Aaron Joseph Cortina | Military Health Care Provider | 2340 Amphibious Dr, Bldg 2012 Suite 125, Virginia Beach, VA 23459-8810 | 2015-10-05 |
1427430297 | Daniel Anthony Leonesio | Military Health Care Provider | 1432 Pandoria Ct, Virginia Beach, VA 23455-3738 | 2015-06-29 |
1346659570 | Nicholas Charles Edward Rohde | Military Health Care Provider | 4946 Juno Rd, Virginia Beach, VA 23455-2244 | 2014-08-13 |
Find all providers in VIRGINIA BEACH |
City | VIRGINIA BEACH |
Zip Code | 23521 |
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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.