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Individual

SHAWN JAMES O'DONNELL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-6444
(407) 445-3515
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-6444
(407) 445-3515

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122600500
FL
Enumeration date
03/12/2019
Last updated
09/09/2024
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