Healthcare Provider Details
I. General information
NPI: 1114886736
Provider Name (Legal Business Name): PATHFINDERS JAX INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
668 TWILIGHT LN
SAINT AUGUSTINE FL
32095-0085
US
IV. Provider business mailing address
668 TWILIGHT LN
SAINT AUGUSTINE FL
32095-0085
US
V. Phone/Fax
- Phone: 678-640-9846
- Fax:
- Phone: 678-640-9846
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
SIGMON
Title or Position: OWNER
Credential: PA-C
Phone: 678-640-9846