Individual
ERICA LYNNE O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1400 HAND AVE STE K, ORMOND BEACH, FL 32174-8195
(386) 671-2771
(386) 671-6458
Mailing address
1400 HAND AVE, SUITE K, ORMOND BEACH, FL 32174-8194
(386) 671-2771
(386) 671-6458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7905
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010034
FHCP
—
01
—
01768
MEDICARE
FL
05
—
263358200
—
FL
01
—
4046734003
CIGNA
FL
01
—
7512263
AETNA
FL
01
—
P00370444
MEDICARE RAILROAD
FL
Enumeration date
07/05/2006
Last updated
09/11/2023
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