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Organization

KHARIS EPHRATA PSYCHIATRIC SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUBY ODAMTTEN APRN (OWNER)
(407) 775-0248
Entity
Organization

Contact information

Practice address
1030 WILDMEADOW RUN, WINTER PARK, FL 32792-3032
(407) 775-0248
(407) 951-7688
Mailing address
587 E STATE ROAD 434 UNIT 1025, LONGWOOD, FL 32750-5284
(407) 775-0248
(321) 282-1448

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
I DO NOT HAVE SUCH NUMBERS
Enumeration date
03/20/2022
Last updated
04/17/2025
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