Healthcare Provider Details

I. General information

NPI: 1124939434
Provider Name (Legal Business Name): MEDFORCE CLINICAL SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 SILVERLEAF VILLAGE DR
SAINT AUGUSTINE FL
32092-3192
US

IV. Provider business mailing address

1775 US HIGHWAY 1 S # 1058
SAINT AUGUSTINE FL
32084-4238
US

V. Phone/Fax

Practice location:
  • Phone: 904-875-7136
  • Fax: 904-978-1138
Mailing address:
  • Phone: 904-875-7136
  • Fax: 904-978-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE ODOM
Title or Position: OWNER/CEO
Credential: APRN
Phone: 904-891-1323