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

Dr. Jacquelyn H Nystrom, MD

Individual provider Family Medicine Physician · NPI 1083818553

Dr. Jacquelyn H Nystrom, MD is a Family Practice in Orlando, Florida. Qualified in 2004, 22 years ago. Practices with Adventhealth Primary Care Network Inc, a 410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
22
Licensed in
FL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9975 Tavistock Lake Blvd Ste 220
Orlando, FL 32827-7559
Phone: (407) 930-7901
Fax: (407) 930-7806
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME94368 (FL)

Record details

NPI number1083818553
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 11, 2007
Last updated in NPPESFebruary 24, 2015

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Adventhealth Primary Care Network Inc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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