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Contact Information

SILOAM MEDICAL
15123 OGDEN LOOP
ODESSA, FL33556-4633
 Phone: 860-268-6617
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Cornea and External Diseases Specialist

207WX0120X 18 Physician/Ophthalmology
 

Glaucoma Specialist

207WX0009X 18 Physician/Ophthalmology
 

Ophthalmic Plastic and Reconstructive Surgery

207WX0200X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for SILOAM MEDICAL · (Female)

NPI Number 1154996072
Status Active
Credentials
Entity Individual
Enumeration date 05/24/2021
Last updated 01/30/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • FL Medicaid 108311400
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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