Individual
ORENTA M ODUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1220 E VENICE AVE, VENICE, FL 34285-7151
(941) 484-5000
(941) 484-4414
Mailing address
1220 E VENICE AVE, VENICE, FL 34285-7151
(941) 484-5000
(941) 484-4414
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP93046659
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002051400
—
FL
01
—
DB716Z
MEDICARE NUMBER
FL
Enumeration date
12/05/2005
Last updated
05/18/2015
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