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).
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 |
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
350 Bayside Pkwy, Nokomis, FL 342753458 | 8134824025 |
Street Address |
1505 DELAWARE AVE |
City | FORT PIERCE |
State | FL |
Zip Code | 34950-3975 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 34950 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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 |
Find all providers in FORT PIERCE |
City | FORT PIERCE |
Zip Code | 34950 |
Please comment or provide details below to improve the information on VICTOR E. DE LOACH.
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.