Healthcare Provider Details

I. General information

NPI: 1780104398
Provider Name (Legal Business Name): JESSICA STARK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 MARINER BLVD
SPRING HILL FL
34609-5691
US

IV. Provider business mailing address

7460 LANDMARK DR
SPRING HILL FL
34606-6359
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-9779
  • Fax:
Mailing address:
  • Phone: 352-293-4769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberARNP9257896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: