MEDICARE: JESSICA L CO MSN, APRN, RN

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	204F00000X	Transplant Surgery Physician	11009975	FL
2	363LF0000X	Family Nurse Practitioner	11738	OH
3	363LF0000X	Family Nurse Practitioner	3009141	KY
4	363LP0200X	Pediatric Nurse Practitioner	COA.11738-NP	OH

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	:	1689989683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L CO MSN, APRN, RN

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY # WAYD
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5603
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S PARK RD STE 400
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8353
Country	:	US
Telephone Number	:	954-265-7450
Fax Number	:

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

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	12/19/2025

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