Provider Demographics
NPI:1285630400
Name:ODZER, SHARI-LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SHARI-LYNN
Middle Name:
Last Name:ODZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N HIATUS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5213
Mailing Address - Country:US
Mailing Address - Phone:954-437-4800
Mailing Address - Fax:954-437-6628
Practice Address - Street 1:MEMORIAL HOSPITAL SOUTH
Practice Address - Street 2:3600 WASHINGTON STREET
Practice Address - City:HOLLYWOOD,
Practice Address - State:FL
Practice Address - Zip Code:33021-8216
Practice Address - Country:US
Practice Address - Phone:954-518-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME632492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31871OtherBLUE CROSS BLUE SHIELD
FL250375100Medicaid
FLG28105Medicare UPIN
FL250375100Medicaid