Individual provider Active NPI

Robert Leslie Odell, M.D.

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1942315338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59026 Issued in FL
Practice address
4002 N Ocean Blvd
Fort Lauderdale, FL 33308-6420
Phone
(954) 563-6784
Fax
(954) 563-6324
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59026 FL Primary

Addresses

Primary practice location

4002 N Ocean Blvd
Fort Lauderdale, FL 33308-6420

Mailing address

4002 N Ocean Blvd
Fort Lauderdale, FL 33308-6420
Phone (954) 563-6784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000317 FL Practitioner - Family Practice 6204015662 Reassigns benefits to 1 organization
Practice locations: Ft Lauderdale, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University Central del Caribe Escuela de Medicina, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4002 N Ocean Blvd
Fort Lauderdale, FL 33308-6420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59026FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office Force CurrentSince Feb 8, 2022 Accepting new patients
Robert L Odell MD Family Medicine PastSince Oct 1, 2001 Accepting new patients

Locations

5237 Summerlin Commons Blvd
Ste 400
Fort Myers, FL 33907
Phone (216) 282-4749

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942315338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 N OCEAN BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086420",
            "telephone_number": "954-563-6784",
            "fax_number": "954-563-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 N OCEAN BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086420",
            "telephone_number": "954-563-6784",
            "fax_number": "954-563-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "ROBERT",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "59026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.