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

Mr. Jody Vicencio Crisostomo, PAC

Individual provider Physician Assistant · NPI 1700829033

Mr. Jody Vicencio Crisostomo, PAC is a Physician Assistant in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

4243 Sunbeam Rd Ste 6
Jacksonville, FL 32257-8975
Phone: (904) 737-1838
Fax: (904) 737-1206
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA1911 (FL)

Record details

NPI number1700829033
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 14, 2006
Last updated in NPPESApril 11, 2008

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