JORGE JOSE PESQUERA (NPI# 1811315112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811315112 |
| Entity Type | Individual |
| Full Name | JORGE JOSE PESQUERA |
| Practice Address |
1350 Hickory St Melbourne FL 32901-3224 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3214341771 |
| Practice Fax Number | 3214341775 |
| Mailing Telephone | 3214341771 |
| Mailing Fax Number | 3219517408 |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-03-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME140308 | FL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | ME140308 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | LD155 | 01 |
| FL | 102965900 | 05 | |
| FL | FL RR MEDICARE | P02367912 | 01 |
| Street Address |
1350 HICKORY ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159670 | Igor Balatsky | Internal Medicine | 1350 Hickory St, Hrmc/hospitalist Program, Melbourne, FL 32901-3224 | 2005-07-29 |
| 1346855301 | Anushree Patel | Anesthesiologist Assistant | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-09-15 |
| 1316565492 | Megan Bellinger | Dietitian, Registered | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-07-06 |
| 1427673011 | Jessica Joy Milnor | Nurse Anesthetist, Certified Registered | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-06-10 |
| 1487274205 | Eric Cuthbert | Registered Nurse | 1350 Hickory St, Melbourne, FL 32901-3224 | 2020-04-22 |
| 1366061970 | Lisa Kistler | Pharmacist | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-04-14 |
| 1194344168 | Tracy Eichelberger | Respiratory Therapist, Registered | 1350 Hickory St, Melbourne, FL 32901-3278 | 2020-04-10 |
| 1477198752 | Matthew Robert Ferraro | Pharmacist | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-11-11 |
| 1356983092 | Parvin Deidri Daneshvar | Registered Nurse | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-10-15 |
| 1972155489 | David Nester Lucas | Family Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2019-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457481418 | Scott L Gold Md LLC | Psychiatry & Neurology | 1535 W Nasa Blvd, Suite A, Melbourne, FL 32901 | 2007-03-07 |
| 1154354561 | Ronald Albert Turck Jr. | Psychiatry & Neurology | 21 Suntree Pl Ste 101, Melbourne, FL 32940-7600 | 2006-07-09 |
| 1841248887 | Diana I Skirk | Psychiatry & Neurology | 2571w Eau Gallie Blvd, Suite 4, Melbourne, FL 32935-8302 | 2006-05-04 |
| 1730155961 | Richard Mahlon Unger Jr. | Psychiatry & Neurology | 116 Silver Palm Ave, Melbourne, FL 32901-3172 | 2006-02-27 |
| 1609866136 | Bhuvaneswari K Dandapani | Psychiatry & Neurology | 1223 Gateway Dr # 2g, Melbourne, FL 32901-2607 | 2005-10-26 |
| 1154311652 | Timothy D Carter | Psychiatry & Neurology | 1223 Gateway Dr Ste 2g, Melbourne, FL 32901-2607 | 2005-10-26 |
| 1649266982 | Maya Stamboliyska | Psychiatry & Neurology | 6105 N Wickham Rd, 411682, Melbourne, FL 32941-7001 | 2005-09-22 |
| 1831199850 | Richard Paul Newman | Psychiatry & Neurology | 709 S. Harbor City Blvd., Suite 100, Melbourne, FL 32901-1936 | 2005-08-01 |
| 1811448954 | Brevard Regional Hyperbaric Center | Psychiatry & Neurology | 1698 W Hibiscus Blvd, Suite B, Melbourne, FL 32901 | 2016-10-24 |
| 1154709384 | Tiffany H Green | Psychiatry & Neurology | 1350 Hickory St, Melbourne, FL 32901-3224 | 2015-05-07 |
| Find all providers in MELBOURNE | ||||
Please comment or provide details below to improve the information on JORGE JOSE PESQUERA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.