Eduardo Pena, IDHS

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Uscgc Valiant - Commanding Officer
Naval Station Mayport - 280101
Jacksonville, FL 32228

Phone

(410) 507-6476

NPI assigned

Aug 24, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1235913724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER USCGC CUTTER VALIANT",
            "address_2": "NAVAL STATION MAYPORT PO BOX 280101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32228",
            "telephone_number": "410-507-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USCGC VALIANT - COMMANDING OFFICER",
            "address_2": "NAVAL STATION MAYPORT - 280101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32228",
            "telephone_number": "410-507-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "EDUARDO",
        "credential": "IDHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Pena-Ariet, M.D.
• Rodolfo Pena-Ariet, M.D.
• Javier Pena-Garzon
• Alejandro Pena Jr., MD
• Ashley Brandt Dickinson Pena, MD
• Emmanuel Pena, D.O.
• Isangel Milmar Pena
• Joanna Pena, APRN
• Louise Pena, RBT
• Rose Marie Pena

• Independent Duty Corpsman in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Independent Duty Corpsman in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.