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

Jacquelyn Medina, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780143628

Jacquelyn Medina, DO is a Dermatology in Jacksonville Beach, Florida. Qualified in 2019, 7 years ago. Practices with Aqua Dermatology of Florida, PA, a 184-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1361 13th Ave S Ste 180
Jacksonville Beach, FL 32250-3235
Phone: (904) 247-4300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2001 Kingsley Ave, Orange Park, FL 32073-5148 — (904) 639-2000

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence OS19989 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780143628
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 19, 2019
Last updated in NPPESJuly 3, 2023
Certification dateJuly 3, 2023
Mailing address2001 Kingsley Ave, Orange Park, FL 32073-5148

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Aqua Dermatology Of Florida, Pa — 184 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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