Doctor profile · Federal record
Dr. Jonathan Vicencio
Certified Registered Nurse Anesthetist (CMS: Certified Registered Nurse Anesthetist (CRNA)) · Palm Coast, FL
- NPI 1790315307
- Accepts Medicare
- 7 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
88 Emerald Lake Dr
Palm Coast, FL 321371311
(631) 455-3034
Credentials & registration
- NPI registered
- January 2020 — 6 yrs on file
- Year of graduation
- 2019 — 7 yrs since
- Specialty taxonomy
- 367500000X — NUCC code
- State license (1)
- Florida #APRN11005783
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1790315307. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$66
Transactions
2
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Edwards Lifesciences Corporation | 2 | $66.27 |
By nature of payment
Hospital affiliations
Frequently asked questions
What is Dr. Jonathan Vicencio's medical specialty?
Dr. Jonathan Vicencio practices Certified Registered Nurse Anesthetist in Palm Coast, FL.
Where does Dr. Jonathan Vicencio practice?
Dr. Jonathan Vicencio practices at 88 Emerald Lake Dr, Palm Coast, FL 321371311. Office phone: 6314553034.
What is Dr. Jonathan Vicencio's NPI?
Dr. Jonathan Vicencio's National Provider Identifier (NPI) is 1790315307, issued by NPPES.
Does Dr. Jonathan Vicencio accept Medicare assignment?
Yes. Dr. Jonathan Vicencio accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.