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Organization
PURPLE DOGFISH LLC
Active
Organization
PURPLE DOGFISH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA MARIE ODERMANN (DO)
(541) 954-3698
Entity
Organization
Contact information
Practice address
6150 EDGELAKE DR, SARASOTA, FL 34240-8803
(541) 954-3698
Mailing address
PO BOX 18186, SARASOTA, FL 34276-1186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/29/2020
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