Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrea Moreno-Lackman, ARNP

Individual provider Nurse Practitioner · NPI 1689984106

Andrea Moreno-Lackman, ARNP is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2012, 14 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
14
Licensed in
FL
In the registry since
2010
What do these letters mean?
ARNP — Advanced Registered Nurse Practitioner
The title some states use for an advanced practice nurse.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence ARNP9348867 (FL)

Record details

NPI number1689984106
Entity typeIndividual (Type 1)
GenderFemale
Credentials ARNP
Sole proprietorNo
NPI enumeratedOctober 18, 2010
Last updated in NPPESOctober 5, 2020
Certification dateOctober 5, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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