Provider Demographics
NPI:1346122041
Name:DEMARCO, KODEE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:KODEE
Middle Name:MARIE
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15449 SE 105TH TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-4637
Mailing Address - Country:US
Mailing Address - Phone:407-765-9356
Mailing Address - Fax:
Practice Address - Street 1:817 NW 56TH TER STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6401
Practice Address - Country:US
Practice Address - Phone:407-765-9356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily