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

Laura Lica

Individual provider Physician Assistant · NPI 1104692664

Laura Lica is a Physician Assistant in Jacksonville, Florida. Qualified in 2024, 2 years ago. Practices with St Davids Heart and Vascular PLLC, a 198-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3900 University Blvd S
Jacksonville, FL 32216-4331
Phone: (904) 222-6656
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104692664
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 27, 2023
Last updated in NPPESJuly 27, 2024
Certification dateJuly 27, 2024
Mailing address14051 Beach Blvd Apt 4212, Jacksonville, FL 32250-1837

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice St Davids Heart And Vascular Pllc — 198 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Jacksonville