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General NPI Number Information
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NPI Number | 1790503407
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Entity Type | Individual
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Provider Name | PATRICK RAYMOND ODONNELL JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 29605 US 19 N STE 150
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City | CLEARWATER
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State | FL
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Zip | 33761-1538
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Country | US
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Telephone | 727-667-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 29605 US HIGHWAY 19 N STE 150
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City | CLEARWATER
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State | FL
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Zip | 33761-1538
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Country | US
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Telephone | 727-797-7600
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Fax | 727-797-7655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTT42394
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License Number State | FL
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