Provider Demographics
NPI:1831584382
Name:ODONOHOE, CATHARINE (ARNP)
Entity type:Individual
Prefix:
First Name:CATHARINE
Middle Name:
Last Name:ODONOHOE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 ULMERTON RD STE 9A
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3526
Mailing Address - Country:US
Mailing Address - Phone:727-588-7600
Mailing Address - Fax:727-230-9194
Practice Address - Street 1:5985 49TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2111
Practice Address - Country:US
Practice Address - Phone:727-527-5060
Practice Address - Fax:727-230-9194
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9373541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014843600Medicaid