| Doctor Name: | MS. SUSAN NANCY ODELL |
| NPI Number: | 1053385211 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC CDE |
| License Number: | PA9101438 |
| Business Practice Address: | 8399 W Oakland Park Boulevard Suite A Sunrise, FL - 33351 |
| Business Phone Number: | 9547414181 |
| Business Fax Number: | 9547468699 |
| Mailing Address: | 401 Sw 4th Avenue, #1500 FORT LAUDERDALE |
| State: | FL |
| Postal Code: | 33315 |
| Phone Number: | 9544626793 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2006 |
| NPI Last Update Date: | 09/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9101438 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |