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General NPI Number Information
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NPI Number | 1942780895
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Entity Type | Organization
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Legal Business Name | OMEGA HEALTH CENTER, INC.
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 800 VIRGINIA AVE STE 14
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City | FORT PIERCE
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State | FL
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Zip | 34982-5829
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Country | US
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Telephone | 772-460-9811
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Fax |
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Provider Business Mailing Address
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Address Line | 800 VIRGINIA AVE SUITE 14
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City | FORT PIERCE
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State | FL
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Zip | 34982
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID NEMBHARD
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Credential |
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Telephone | 772-460-9811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME75634
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME75634
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | ME75634
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME75634
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME75634
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License Number State | FL
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