Nayomi E Omura (NPI# 1710936612, PAC ID# 4486843422) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1710936612 |
| PAC ID by PECOS | 4486843422 |
| Professional Enrollment ID | I20110106000811 |
| Full Name | Nayomi E Omura |
| Organization Legal Name | WATERS EDGE DERMATOLOGY LLC |
| Address |
1400 Se Goldtree Dr Suite 107 Port St Lucie FL 34952-7582 |
| Phone Number | 7723353550 |
| Gender | F |
| Medical School | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 6901893155 |
| Number of Group Practice Members | 68 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100044 | MARTIN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1400 Se Goldtree Dr, Suite 107, Port St Lucie, FL 34952-7582 | 7723353550 | WATERS EDGE DERMATOLOGY LLC |
| Organization Legal Name | WATERS EDGE DERMATOLOGY LLC |
| Physicians | 65 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan M Carp | Dermatology | Waters Edge Dermatology LLC | 6642 W Atlantic Ave, Delray Beach, FL 33446-1616 |
| Stefan Doig | Dermatology | Waters Edge Dermatology LLC | 2910 Se3rd Ct, Ocala, FL 34471-0485 |
| Christopher Spock | Dermatology | Waters Edge Dermatology LLC | 121 S State Rd, Suite 7, Wellington, FL 33414-4338 |
| Gioconda A Boaz | Physician Assistant | Waters Edge Dermatology LLC | 2685 Forest Hill Blvd, West Palm Beach, FL 33406-5930 |
| Claudia Alejandra Vera | Physician Assistant | Waters Edge Dermatology LLC | 562 N Us Hwy 27, Lady Lake, FL 32159-3776 |
| Shery M Varghese | Dermatology | Waters Edge Dermatology LLC | 590 Malabar Rd Se, Suite 2, Palm Bay, FL 32907-3108 |
| Michael T Siino | Physician Assistant | Waters Edge Dermatology LLC | 7605 Conroy Windermere Rd, Orlando, FL 32835-2646 |
| Laura B Destefano | Dermatology | Waters Edge Dermatology LLC | 2484 Caring Way, Unit C, Port Charlotte, FL 33952-5306 |
| Theodore A Schiff | Dermatology | Waters Edge Dermatology LLC | 600 Village Square Xing, Palm Beach Gardens, FL 33410-4543 |
| John Gregory Neily | Dermatology | Waters Edge Dermatology LLC | 4315 Tamiami Trl S, Venice, FL 34293-5117 |
| Street Address |
1400 SE GOLDTREE DR SUITE 107 |
| City | PORT ST LUCIE |
| State | FL |
| Zip | 34952-7582 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diane M Krutzler | General Surgery | Palm Beach General Surgery LLC | 1400 Se Goldtree Dr, Suite 102 104, Port St. Lucie, FL 34952-7582 |
| John P Minni | Dermatology | Waters Edge Dermatology LLC | 1400 Se Goldtree Dr, Suite 107, Port St Lucie, FL 34952-7582 |
| Adam D Kurtin | General Surgery | Palm Beach General Surgery LLC | 1400 Se Goldtree Dr, Suite 102 104, Port St. Lucie, FL 34952-7582 |
| Rene M Loyola | General Surgery | Palm Beach General Surgery LLC | 1400 Se Goldtree Dr, Suite 102 104, Port St. Lucie, FL 34952-7582 |
| Shoshana D Hacker | General Surgery | Palm Beach General Surgery LLC | 1400 Se Goldtree Dr, Suite 102 104, Port St. Lucie, FL 34952-7582 |
| Alfredo Sy | Physician Assistant | Waters Edge Dermatology LLC | 1400 Se Goldtree Dr, Suite 107, Port St Lucie, FL 34952-7582 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Claudia Patricia Santamaria | Nurse Practitioner | Primary Care Associates, Pa | 8483 S Us, Suite 19, Port St Lucie, FL 34952 |
| Heather L Hackney | Qualified Audiologist | James L Autin Md Pa | 10377s Us One Hwy 101, Port Saint Lucie, FL 34952 |
| Cynthia J Rogers | Dermatology | 8503 S Us, Suite 1, Port St Lucie, FL 34952 | |
| Anthony Glenn Rogers | Anesthesiology | Port St Lucie Pain Management Pllc | 8235s Us Hwy 1, Port St Lucie, FL 34952 |
| Diane Leigh Pugh | Family Medicine | Primary Care Associates, Pa | 8483 S Us, Suite 19, Port St Lucie, FL 34952 |
| James L Autin | Otolaryngology | James L Autin Md Pa | 10377s Us One Hwy 101, Port Saint Lucie, FL 34952 |
| Carolyn A Rawdon | Nurse Practitioner | Primary Care Associates, Pa | 8483 S Us, Suite 19, Port St Lucie, FL 34952 |
| Kenneth Weiss | Otolaryngology | James L Autin Md Pa | 10377s Us One Hwy 101, Port Saint Lucie, FL 34952 |
| Ravi Mehan | Internal Medicine | Primary Care Associates, Pa | 8483 S Us, Suite 19, Port St Lucie, FL 34952 |
| Glynnis Jayne Lyons | General Practice | Primary Care Associates, Pa | 8483 S Us, Suite 19, Port St Lucie, FL 34952 |
| Find all physicians in zip 34952 | |||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
| Specialty | DERMATOLOGY |
| City + Specialty | PORT ST LUCIE + DERMATOLOGY |
Please comment or provide details below to improve the information on Nayomi E Omura.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.