OMAR ANTONIO PESCADOR


Address: Seal Team 10 Medical Department, Bldg 3808, Virginia Beach, VA 23521
Phone: 9178483454

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address SEAL TEAM 10 MEDICAL DEPARTMENT
BLDG 3808
City VIRGINIA BEACH
State VA
Zip Code 23521

Providers in the same zip code

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 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
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

Competitor

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City VIRGINIA BEACH
Zip Code 23521

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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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