Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anthony Atwood Premo, APRN, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1033840806

Anthony Atwood Premo, APRN, AGACNP-BC is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2022, 4 years ago. Practices with Cleveland W. Randolph, Jr, MD, PA, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2022
Specialties on file
4
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

See every abbreviation used in this directory →

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Practice location Address checks out

14785 Old Saint Augustine Rd Ste 100
Jacksonville, FL 32258-7407
Phone: (904) 456-0017
Fax: (904) 456-0018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence APRN11020380 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence APRN11020380 (FL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence APRN11020380 (FL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence APRN11020380 (FL)

Record details

NPI number1033840806
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN , AGACNP-BC
Sole proprietorNo
NPI enumeratedJune 22, 2022
Last updated in NPPESMarch 13, 2025
Certification dateMarch 13, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cleveland W. Randolph, Jr, Md, Pa — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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