Healthcare Provider Details

I. General information

NPI: 1336564038
Provider Name (Legal Business Name): ANDREA ODVARKO ARNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10920 BAYMEADOWS RD STE 1
JACKSONVILLE FL
32256-4571
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 904-712-9362
  • Fax: 904-712-9390
Mailing address:
  • Phone: 727-322-3439
  • Fax: 800-928-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN11049507
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: