Provider Demographics
NPI:1588368724
Name:NEW ANCHOR HEALTHCARE
Entity type:Organization
Organization Name:NEW ANCHOR HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-682-2529
Mailing Address - Street 1:2750 NW 174TH ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:FL
Mailing Address - Zip Code:32693-8196
Mailing Address - Country:US
Mailing Address - Phone:352-682-2529
Mailing Address - Fax:
Practice Address - Street 1:3280 W POWERS AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:FL
Practice Address - Zip Code:32619-2403
Practice Address - Country:US
Practice Address - Phone:352-682-2529
Practice Address - Fax:352-577-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty