STACEY J ODDMAN (NPI# 1003921222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003921222 |
| Entity Type | Individual |
| Full Name | STACEY J ODDMAN |
| Practice Address |
4004 N Ocean Blvd Ft Lauderdale FL 33308-6420 |
| Practice Telephone | 9545641330 |
| Practice Fax Number | 9545640538 |
| Mailing Telephone | 9545641330 |
| Mailing Fax Number | 9545640538 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
ME87585 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 272897400 | 05 |
| Street Address |
4004 N OCEAN BLVD |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33308-6420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164539011 | Lise M Lambert | Family Medicine | 4004 N Ocean Blvd, Suite 101, Ft Lauderdale, FL 33308-6420 | 2006-08-24 |
| 1750496998 | Zonia D Acosta | Internal Medicine | 4004 N Ocean Blvd, Ft Lauderdale, FL 33308-6420 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558788 | Marina Silva Ferreira | Student in an Organized Health Care Education/Training Program | Univ of Miami Miller School of Med Holy Cross Hospital, 4725 N Federal Highway, Fort Lauderdale, FL 33308 | 2020-05-06 |
| 1013538040 | Mehak Bansal | Student in an Organized Health Care Education/Training Program | 4725 N Federal Highway University of Miami, Miller School of Medicine Holy Cross Hospital Internal, Fort Lauderdale, FL 33308 | 2020-04-30 |
| 1285269266 | Roman Castell | Massage Therapist | 2480 E Commercial Blvd Ste 3, Fort Lauderdale, FL 33308 | 2020-03-10 |
| 1124667969 | Icarevip, Inc | Internal Medicine | 4800 N. Federal Highway, Suite 200, Fort Lauderdale, FL 33308 | 2019-12-26 |
| 1629612932 | Lana A Simmonds | Nurse Practitioner | 4390 N. Federal Hwy, Unit 101, Fort Lauderdale, FL 33308 | 2019-10-30 |
| 1063997260 | Kneaded Therapy, Inc | Physical Medicine & Rehabilitation | 2746 E Commerical Blvd., Ft. Lauderdale, FL 33308 | 2018-10-03 |
| 1518452184 | Colleen Lynn Culbertson | Nurse Anesthetist, Certified Registered | 1930 Ne 47th St Ste 308, Ft Lauderdale, FL 33308 | 2018-06-26 |
| 1962910562 | Healing Therapy Center Pllc | Social Worker | Healing Therapy, 1919 Ne 45th Street, Suite 225, Ft. Lauderale, FL 33308 | 2018-01-17 |
| 1376066647 | Carlos Jose Garcia | Student in an Organized Health Care Education/Training Program | 4725 North Federal Highway Suite 501, Fort Lauderdale, FL 33308 | 2017-07-19 |
| 1407381940 | Heather Hickson Lac LLC | Clinic/Center | 5353 North Federal Highway, Ste 220, Fort Lauderdale, FL 33308 | 2017-04-21 |
| Find all providers in zip 33308 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366629370 | Neri Franzon | Family Medicine | 4390 N Federal Hwy Ste 101, Ft Lauderdale, FL 33308-5215 | 2008-01-22 |
| 1831579762 | Peter Roger Genovese | Family Medicine | 936 Intracoastal Dr, Ph 4, Ft Lauderdale, FL 33304-3640 | 2015-06-05 |
| 1164539011 | Lise M Lambert | Family Medicine | 4004 N Ocean Blvd, Suite 101, Ft Lauderdale, FL 33308-6420 | 2006-08-24 |
| 1215988837 | United Services of South Florida | Family Medicine | 2021 E Commercial Blvd, Suite 308, Ft Lauderdale, FL 33308-3763 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598105 | Foundations Medical Center Pllc | Family Medicine | 4467 Commons Dr W Ste F-g, Destin, FL 32541-8454 | 2020-11-04 |
| 1831704345 | Vasundhara Kuchibhotla | Family Medicine | 1630 Sw 75th Ter, Gainesville, FL 32607-6604 | 2020-09-11 |
| 1356952170 | Discreet Health Solutions, LLC | Family Medicine | 7124 Pelican Island Dr, Tampa, FL 33634-7463 | 2020-08-14 |
| 1033728019 | Nana Aisha Garba | Family Medicine | 11200 Sw 8th St Ahc2 Rm 589b, Miami, FL 33199-0001 | 2020-07-27 |
| 1043838451 | Lisa M Parker | Family Medicine | 7955 Bay St Ste 2, Sebastian, FL 32958-3282 | 2020-07-13 |
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1588287239 | Sarai L Gonzalez | Family Medicine | 16182 Nw 21st St, Pembroke Pines, FL 33028-1255 | 2020-05-28 |
| 1184247033 | Wellness Solutions 2020 LLC | Family Medicine | 2300 N Commerce Pkwy Ste 321, Weston, FL 33326-3257 | 2020-05-27 |
| 1780207910 | Homeville Medical Care | Family Medicine | 11040 Nw 18th Ct, Plantation, FL 33322-3407 | 2020-05-21 |
| 1942829536 | Health Medical Ultra Limited Liability Company | Family Medicine | 1760 Havendale Blvd Nw, Winter Haven, FL 33881-1224 | 2020-04-13 |
| Find all providers with the same taxonomy | ||||
| City | FT LAUDERDALE |
| Zip Code | 33308 |
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| 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.