MEDICARE: ASHLEY ODOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center	813994458	FL

General Provider Information

NPI Number	:	1750824470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ODOM

Provider Business Mailing Address
First Line	:	5003 WINTER GARDEN PKWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-2031
Country	:	US
Telephone Number	:	772-207-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	5003 WINTER GARDEN PKWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-2031
Country	:	US
Telephone Number	:	772-207-0566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

Similar Medicare Providers

1508170366 — MRS. TERESA PATRICIA MCELROY LMSW
Practice Location Address:

3632 PIERCE ST
SIOUX CITY, IA
51104-2031

Practice Phone: 712-258-8033
Practice Fax:

1609861467 — JEAN P WINFIELD APN
Practice Location Address:

5804 INDIAN PINES BLVD
FORT PIERCE, FL
34951-2302

Practice Phone: 772-828-3752
Practice Fax:

1871558387 — BUTTERFIELD OXYGEN AND MEDICAL INC
Practice Location Address:

5009 TURNPIKE FEEDER RD , SUITE A
FORT PIERCE, FL
34951-2217

Practice Phone: 772-465-7476
Practice Fax: 772-465-6183

1932147063 — DR. EMILIO R MARTINEZ DDS
Practice Location Address:

5110 TURNPIKE FEEDER RD
FORT PIERCE, FL
34951-5020

Practice Phone: 772-465-3443
Practice Fax:

1013959394 — LAKEWOOD PARK WALK-IN CLINIC, LLC
Practice Location Address:

5059 TURNPIKE FEEDER RD
FORT PIERCE, FL
34951-2246

Practice Phone: 772-465-8588
Practice Fax:

1467497198 — VALUE HEALTH CONSULTANTS INC
Practice Location Address:

5009 TURNPIKE FEEDER RD
FORT PIERCE, FL
34951-2217

Practice Phone: 772-489-3700
Practice Fax: 772-489-3714

Directions to “ ASHLEY ODOM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.