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

Jonathan Divine, DO

Individual provider Family Medicine Physician · NPI 1710173968

Jonathan Divine, DO is a Family Practice in Jacksonville, Florida. Graduated from West Virginia School of Osteopathic Medicine in 2007, 19 years ago. Practices with St Vincent's Ambulatory Care Inc, a 302-clinician group and offers telehealth. Licensed in Florida.

Years since qualifying
19
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
FL
In the registry since
2007
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.

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Practice location Address checks out

3059 Edgewood Ave W
Jacksonville, FL 32209-2207
Phone: (904) 647-3180
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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 OS 10858 (FL)

Record details

NPI number1710173968
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 21, 2007
Last updated in NPPESOctober 8, 2025
Certification dateOctober 8, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesOSTEOPATHIC MANIPULATIVE MEDICINE
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2007 (19 years in practice)
Group practice St Vincent'S Ambulatory Care Inc — 302 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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