Provider Demographics
NPI:1841219086
Name:REPKO, JODI (NP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:REPKO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 NE 12TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6029
Mailing Address - Country:US
Mailing Address - Phone:352-368-9734
Mailing Address - Fax:727-507-3618
Practice Address - Street 1:1500 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4004
Practice Address - Country:US
Practice Address - Phone:352-351-3407
Practice Address - Fax:352-351-7602
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3293312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P65183Medicare UPIN