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

Jonathan Vicencio

Individual provider Certified Registered Nurse Anesthetist · NPI 1790315307

Jonathan Vicencio is a Certified Registered Nurse Anesthetist (CRNA) in Palm Coast, Florida. Qualified in 2019, 7 years ago. Practices with Anesthesia Physician Solutions of North Florida LLC, a 286-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2020

Practice location Address checks out

88 Emerald Lake Dr
Palm Coast, FL 32137-1311
Phone: (631) 455-3034
Show map & directions

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

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence APRN11005783 (FL)

Record details

NPI number1790315307
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 22, 2020
Last updated in NPPESJanuary 22, 2020
Certification dateJanuary 22, 2020
Mailing address88 Emerald Lake Dr, Palm Coast, FL 32137-1311

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Anesthesia Physician Solutions Of North Florida Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Palm Coast