VICTOR E. DE LOACH


Address: 1505 Delaware Ave, Fort Pierce, FL 34950-3975
Phone: 7724611402

VICTOR E. DE LOACH (NPI# 1982693123) 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) 1982693123
Entity Type Individual
Full Name VICTOR E. DE LOACH
Credential M.D.
Practice Address 1505 Delaware Ave
Fort Pierce
FL 34950-3975
Mailing Address 350 Bayside Pkwy
Nokomis
FL 34275-3458
Practice Telephone 7724611402
Practice Fax Number 8445404795
Mailing Telephone 8134824025
Enumeration Date 2005-10-20
Last Update Date 2020-06-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine MD.19935 AL Allopathic & Osteopathic Physicians
N 207V00000X Obstetrics & Gynecology 78151 FL Allopathic & Osteopathic Physicians
Y 208D00000X General Practice ME78151 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AL 132989 05
FL AETNA 5474634 01
FL AVMED 266278 01
FL FLORIDA BLUE 58949 01
FL 022825500 05
AL 131855 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
350 Bayside Pkwy, Nokomis, FL 342753458 8134824025

Office Location

Street Address 1505 DELAWARE AVE
City FORT PIERCE
State FL
Zip Code 34950-3975

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215938519 Cheryl Elaine Wayne Pediatrics 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2005-08-09
1457993586 Kali Garcia Malpica Nurse Practitioner 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2019-10-10
1851947568 Emily Pham Dentist 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2019-08-18
1396209466 Stanley Jose Guerrero Nurse Practitioner 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2019-01-23
1841771177 Reinaldo Hernandez Silva Nurse Practitioner 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2018-08-24
1366922288 Bonnie Russo Social Worker 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2018-08-20
1770063745 Rene Leyva Quevedo Nurse Practitioner 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2018-08-18
1275078487 Serge Volma Valme Nurse Practitioner 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2016-12-23
1184009052 Melissa Allen Davis Pharmacist 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2015-07-21
1518355403 Florida Community Health Center Pharmacy 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2014-12-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659853018 New Day Counseling & Wellness, LLC Clinic/Center 130 S Indian River Drive Suite 202, Fort Pierce, FL 34950 2018-09-03
1548749351 Jaber's Pharmacy, Inc. Pharmacy 2210 Orange Ave, Fort Pierce, FL 34950 2018-08-13
1386139699 Pas Substance Abuse, Inc. Substance Abuse Rehabilitation Facility 2017 Avenue D, Fort Pierce, FL 34950 2018-06-28
1629573134 Southeastern Dme LLC Durable Medical Equipment & Medical Supplies 200 S Indian River Dr Ste 300, Fort Pierce, FL 34950 2018-03-27
1962903666 Serenity Dme LLC Durable Medical Equipment & Medical Supplies 111 N 2nd St Ste 101, Fort Pierce, FL 34950 2018-02-27
1417463068 Ryan Nippes Counselor 1302 N Lawnwood Cr, Suite B, Fort Pierce, FL 34950 2017-12-19
1639685282 Valencia Worrell Counselor 1302 N Lswnwood Cr, Suite B, Fort Pierce, FL 34950 2017-12-19
1194173153 Angel French Massage Therapist 101 North Us1, Suite 117, Fort Pierce, FL 34950 2016-06-01
1780052951 Alison Hess Physician Assistant 1700 S. 23rd St, Fort Pierce, FL 34950 2015-09-04
1629329784 Dr. Rhaina A Smeds, Psyd Inc. Psychologist 100 Ave A, Ste 2d, Ft. Pierce, FL 34950 2012-09-28
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396166252 M Care Medical Center Inc. General Practice 850 S 21st St, Suite B, Fort Pierce, FL 34950-4893 2013-12-19
1922363043 Stanley Pala General Practice 4180 N Hwy A1a, #505, Fort Pierce, FL 34949-8380 2012-07-05
1538427984 Eavans Duroseau General Practice 506 N 7th St, Fort Pierce, FL 34950-8228 2012-04-23
1104031061 Kendis Archer General Practice 1506 Barcelona Ave, Fort Pierce, FL 34946 2007-05-14
1679665814 Juan D. Maldonado General Practice 1404 S 28th St, Fort Pierce, FL 34947-6999 2006-09-28
1396171633 Sarang Hadaegh General Practice 1505 Delaware Ave, Fort Pierce, FL 34950-3975 2013-09-18
1538439559 Chacko Nebu General Practice 2401 Frist Boulevard, Suite One, Fort Pierce, FL 34950 2012-01-06
1861788036 Tj Medical LLC General Practice 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 2011-06-25
1316233588 Fp Medical General Practice 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 2011-06-25
1952547721 Guillermo G Coquelet General Practice 4640 S 25th St, Fort Pierce, FL 34981-5057 2008-12-30
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Competitor

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City FORT PIERCE
Zip Code 34950

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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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