Provider Demographics
NPI:1831969450
Name:ODYSSEY COMMUNITY MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ODYSSEY COMMUNITY MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-216-7544
Mailing Address - Street 1:1350 SW 57TH AVE STE 313
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5775
Mailing Address - Country:US
Mailing Address - Phone:786-216-7544
Mailing Address - Fax:
Practice Address - Street 1:1350 SW 57TH AVE STE 313
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5775
Practice Address - Country:US
Practice Address - Phone:786-216-7544
Practice Address - Fax:786-216-7543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty