Individual
DR. ESAN ODELL SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.B.A.
Contact information
Practice address
15100 RESCUE WAY, USCG AIR STATION CLEARWATER MEDICAL CLINIC, CLEARWATER, FL 33762-3502
(727) 535-1437
(727) 535-4190
Mailing address
15100 RESCUE WAY, USCG AIR STATION CLEARWATER MEDICAL CLINIC, CLEARWATER, FL 33762-3502
(727) 535-1437
(727) 535-4190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101102764
VA
208D00000X
General Practice Physician
Primary
0101102764
VA
Other
Enumeration date
12/16/2005
Last updated
07/22/2013
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