Individual
JOSHUA E KOLANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C-FNP
Contact information
Practice address
16025 MUIRFIELD DR, ODESSA, FL 33556-2861
(813) 226-3332
(813) 793-7644
Mailing address
PO BOX 22, ODESSA, FL 33556-0022
(813) 226-3332
(813) 793-7644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MK1233357
WV
363L00000X
Nurse Practitioner
Primary
ARPR9328710
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008481300
—
FL
05
—
3810002050
—
WV
01
—
Y048RQ
MEDICARE
FL
Enumeration date
10/13/2005
Last updated
02/24/2022
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