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

Nicole Pauline Detrick

Individual provider Physician Assistant · NPI 1760172761

Nicole Pauline Detrick is a Physician Assistant in Jacksonville, Florida. Qualified in 2023, 3 years ago. Practices with Florida Physician Specialists LLC, a 36-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and Pennsylvania.

Years since qualifying
3
Licensed in
FL, PA
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

6269 Beach Blvd
Jacksonville, FL 32216-2768
Phone: (904) 727-7955
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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 PA9119031 (FL)
Physician Assistant Taxonomy 363A00000X · Licence MA064732 (PA)

Record details

NPI number1760172761
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 11, 2023
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Florida Physician Specialists Llc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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