Vicencio, Jonathan

Vicencio, Jonathan is an individual health care provider with primary practice located at 88 Emerald Lake Dr , Palm Coast FL 32137-1311. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Vicencio, Jonathan can be contacted via phone (631) 455-3034.

Contact Information

Primary practice address
88 Emerald Lake Dr Palm Coast FL 32137-1311
Phone: (631) 455-3034
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN11005783 Florida

Profile Details

NPI number 1790315307
LBN Legal business name Vicencio, Jonathan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2020
Last updated Jan 22nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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