Organization Name: | OMNIHEALTHCARE INC |
NPI Number: | 1134371933 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG K DELIGDISH (BOARD MEMBER) |
Mailing Address: | 95 Bulldog Blvd Suite 202 Melbourne |
State: | FL US |
Postal Code: | 329013188 |
Phone Number: | 3217272990 |
Fax Number: | 3217240455 |
NPI Enumeration Date: | 10/13/2008 |
NPI Last Update Date: | 07/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |