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

Michael Peterson

Individual provider Family Medicine Physician · NPI 1184037020

Michael Peterson is a Family Practice in Jacksonville, Florida. Qualified in 2014, 12 years ago. Practices with St Vincents Medical Center Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
12
Licensed in
FL
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone: (904) 308-7372
Fax: (904) 308-2908
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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 OS13490 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence UO 3884 (FL)

Record details

NPI number1184037020
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 9, 2014
Last updated in NPPESMay 4, 2016

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice St Vincents Medical Center Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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