Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivan Vicente, IDMT

Individual provider Independent Duty Medical Technicians · NPI 1710201553

Ivan Vicente, IDMT is an Independent Duty Medical Technicians in Ellsworth AFB, South Dakota. Registered with an NPI since 2010.

In the registry since
2010

Practice location Address checks out

433 Black Elk Ct
Ellsworth AFB, SD 57706-1847
Phone: (605) 521-3502
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Medical Technicians (primary) Taxonomy 1710I1003X

Record details

NPI number1710201553
Entity typeIndividual (Type 1)
GenderMale
Credentials IDMT
Sole proprietorNo
NPI enumeratedMarch 23, 2010
Last updated in NPPESMarch 23, 2010
Mailing address433 Black Elk Ct, Ellsworth Afb, SD 57706-1847

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