Healthcare Provider Details

I. General information

NPI: 1285604793
Provider Name (Legal Business Name): CLAUDIO E VINCENTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5191 FIRST COAST TECH PKWY 3RD FLOOR
JACKSONVILLE FL
32224-0609
US

IV. Provider business mailing address

5191 FIRST COAST TECH PKWY FL 3
JACKSONVILLE FL
32224-0609
US

V. Phone/Fax

Practice location:
  • Phone: 904-223-3321
  • Fax: 904-223-2169
Mailing address:
  • Phone: 904-223-3321
  • Fax: 904-223-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number0044593
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME44593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: