Hudson, Omar Dean
Hudson, Omar Dean is an individual health care provider with primary practice located at 1223 Gateway Dr Ste 1G , Melbourne FL 32901-2607. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is his primary health care specialty. Hudson, Omar Dean can be contacted via phone (321) 723-0072.Contact Information
Primary practice address
1223 Gateway Dr Ste 1G
Melbourne FL 32901-2607
Phone: (321) 723-0072
Fax: (321) 952-0850
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME103869 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Endocrinology | 2080P0205X | ME103869 | Florida |
Profile Details
| NPI number | 1043417421 |
|---|---|
| LBN Legal business name | Hudson, Omar Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Feb 13th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043417421 | NPPES |
| Florida | Other | 9796123 | AETNA |
| Florida | Other | CQ236Y | AETNA |
| Florida | MEDICAID | 000990300 | AETNA |
| Florida | Other | 29192 | AETNA |
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