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:
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Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
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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