Healthcare Provider Details

I. General information

NPI: 1407762412
Provider Name (Legal Business Name): APRIL TINES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 BEACH BLVD
JACKSONVILLE FL
32216-2706
US

IV. Provider business mailing address

385 WHISPER RIDGE DR
ST AUGUSTINE FL
32092-3777
US

V. Phone/Fax

Practice location:
  • Phone: 904-345-8100
  • Fax:
Mailing address:
  • Phone: 813-285-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11050210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: