Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JODY VICENCIO CRISOSTOMO, PAC
ActiveMR. JODY VICENCIO CRISOSTOMO, PAC is a Physician Assistant healthcare provider located in JACKSONVILLE, Florida. NPI 1700829033 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · JACKSONVILLE, FL
Registration Details
- NPI Number
- 1700829033
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 14, 2006 (20.143323732961 yrs)
- Last Updated
- Apr 11, 2008
- License
-
PA1911 (FL)
Practice Information
- Address
-
4243 SUNBEAM RD STE 6JACKSONVILLE, FL, 322578975Browse FL providers · Browse ZIP 32257
- Phone
- 9047371838
- Fax
- 9047371206
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in JACKSONVILLE, FL
| Name | Credential | NPI |
|---|---|---|
| MR. JASON KOTULA | P.A. | 1548263882 |
| DANIEL A BECK | PA-C | 1780688465 |
| JOHN MICHAEL TIERNEY | PA | 1124023445 |
| KAREN ELAINE MAYES | PA | 1437154887 |
| EDWIN HAUSER | PA | 1760487185 |
| PETER J RIGGS | PA | 1255336574 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.