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DR. OMAR DEAN HUDSON M.D. NPI 1043417421


NPI Information

NPI: 1043417421
Provider Name: DR. OMAR DEAN HUDSON, M.D.
Classification: Pediatrics - 2080P0205X
Entity Type: Individual

Specialization: Pediatric Endocrinology

PECOS Registration: Yes

Address:
1223 GATEWAY DR STE 1G
MELBOURNE, FL
ZIP 32901
Phone: (321) 723-0072
Get Directions

DR. Omar Dean Hudson, M.D. is a pediatric endocrinology pediatrics in Melbourne, FL. The provider is a pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. DR. Omar Dean Hudson, M.D. NPI is 1043417421. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1223 GATEWAY DR STE 1G
MELBOURNE, FL
ZIP 32901-607
Phone: (321) 723-0072
Fax: (321) 952-0850

The NPI 1043417421 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/29/2007 and was last updated on 2/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsME103869FLORIDANo
22080P0205XPediatricsPediatric EndocrinologyME103869FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
19796123OTHERFLORIDAAETNA
2CQ236YOTHERFLORIDAMEDICARE
3000990300MEDICAIDFLORIDA
429192OTHERFLORIDABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.