Individual
RYAN M ODIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1400 S FLORIDA AVE, LAKELAND, FL 33803-2257
(863) 250-5553
Mailing address
1400 S FLORIDA AVE, LAKELAND, FL 33803-2257
(863) 250-5553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618002258
VA
152W00000X
Optometrist
Primary
OPC4935
FL
Other
Enumeration date
06/26/2013
Last updated
03/31/2023
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