Healthcare Provider Details

I. General information

NPI: 1851226658
Provider Name (Legal Business Name): MACHAELA TREVINO WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3627 UNIVERSITY BLVD S STE 200
JACKSONVILLE FL
32216-4256
US

IV. Provider business mailing address

42 THURNHAM LN
ST AUGUSTINE FL
32092-3399
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN11048333
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: