MEDICARE: LYNDA ODERA APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11008253	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11008253	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295359362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDA ODERA APRN

Provider Business Mailing Address
First Line	:	2300 NW 89TH PL FL 3
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33172-2431
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 W OAKLAND PARK BLVD FL 3
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-7500
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	05/08/2026

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Directions to “ LYNDA ODERA APRN” Practice Location

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