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

Taylor Gregory Trace, PA-C

Individual provider Physician Assistant · NPI 1225689599

Taylor Gregory Trace, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2019, 7 years ago. Practices with Millennium Physician Group LLC, a 970-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11513 N Main St
Jacksonville, FL 32218-4002
Phone: (904) 751-6200
Fax: (941) 751-1600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218-7273 — (904) 223-3321
  • 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 — (904) 223-3321

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (FL)

Record details

NPI number1225689599
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 26, 2019
Last updated in NPPESNovember 17, 2020
Certification dateNovember 17, 2020
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Millennium Physician Group Llc — 970 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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