MR. OMAR CORDELL GRANT (NPI# 1831522374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831522374 |
| Entity Type | Individual |
| Full Name | MR. OMAR CORDELL GRANT |
| Credential | PA-C |
| Practice Address |
1801 Se Hillmoor Dr B-109 Port Saint Lucie FL 34952-7553 |
| Mailing Address |
1885 Sw Altman Ave Port St Lucie FL 34953-1010 |
| Practice Telephone | 7723379473 |
| Practice Fax Number | 7723370796 |
| Mailing Telephone | 9545517041 |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2014-05-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1801 SE HILLMOOR DR B-109 |
| City | PORT SAINT LUCIE |
| State | FL |
| Zip Code | 34952-7553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588104582 | Narine Dawkins | Nurse Practitioner | 1801 Se Hillmoor Dr, Suite B-109, Port Saint Lucie, FL 34952-7553 | 2017-02-24 |
| 1902259799 | Unique Helping Hands International, Inc | Assisted Living Facility | 1801 Se Hillmoor Dr, C104, Port Saint Lucie, FL 34952-7553 | 2016-07-18 |
| 1770957334 | Treasure Coast Urgent & Family Care | Clinic/Center | 1801 Se Hillmoor Dr, Bldg. A, Suite 109, Port Saint Lucie, FL 34952-7553 | 2015-11-19 |
| 1992179527 | Treasure Coast Primary Care | Clinic/Center | 1801 Se Hillmoor Dr, Building A Suite 108, Port Saint Lucie, FL 34952-7553 | 2015-11-19 |
| 1518363951 | Family First Physician Services LLC | Family Medicine | 1801 Se Hillmoor Dr, B-109, Port Saint Lucie, FL 34952-7553 | 2014-11-12 |
| 1710398417 | Larry P. Auerbach, Lcsw | Social Worker | 1801 Se Hillmoor Dr, Suite B-106, Port Saint Lucie, FL 34952-7553 | 2014-05-15 |
| 1457696601 | Md 2 Go LLC | Family Medicine | 1801 Se Hillmoor Dr, B109, Port Saint Lucie, FL 34952-7553 | 2012-11-29 |
| 1144476920 | Deborah Ann Kicliter-kelly | Nurse Practitioner | 1801 Se Hillmoor Dr, Suite B109, Port Saint Lucie, FL 34952-7553 | 2008-08-13 |
| 1235336819 | Gregory A Dawkins | Family Medicine | 1801 Se Hillmoor Dr, Suite B-109, Port Saint Lucie, FL 34952-7553 | 2007-06-28 |
| 1104978667 | Mark Steven Maier | Chiropractor | 1801 Se Hillmoor Dr, Suite C-102, Port Saint Lucie, FL 34952-7553 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851890065 | Michael Depalma | Physician Assistant | 1801 Se Hillmoor Dr Ste 109, Port Saint Lucie, FL 34952-7553 | 2018-02-03 |
| 1215446380 | Joseph Marini | Physician Assistant | 537 Nw Lake Whitney Pl Ste 103-106, Port Saint Lucie, FL 34986-1620 | 2017-09-21 |
| 1215959739 | Joseph Stanley Howard | Physician Assistant | 1859 Psl Blvd, Lumar Plaza, Port Saint Lucie, FL 34952 | 2006-07-24 |
| 1225087687 | Jeffrey Norman Johnson | Physician Assistant | 264 Nw Peacock Blvd, Port Saint Lucie, FL 34986-2272 | 2006-05-10 |
| 1366426124 | Penelope Freseman | Physician Assistant | 1701 Se Hillmoor Dr, Suite 5, Port Saint Lucie, FL 34952-7552 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | PORT SAINT LUCIE |
| Zip Code | 34952 |
Please comment or provide details below to improve the information on MR. OMAR CORDELL GRANT.
| 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.