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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

NPI # 1154996072
LBN Legal business name SILOAM MEDICAL
Authorized official NICHOLAS BOTTARO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/24/2021
Last updated 01/30/2025 - More than a year ago
Identifiers
FL Medicaid 108311400
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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