MEDICARE: ANTHONY ATWOOD PREMO APRN, AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN11020380	FL
2	363LA2100X	Acute Care Nurse Practitioner	APRN11020380	FL
3	363LG0600X	Gerontology Nurse Practitioner	APRN11020380	FL
4	363LA2200X	Adult Health Nurse Practitioner	APRN11020380	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033840806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY ATWOOD PREMO APRN, AGACNP-BC

Provider Business Mailing Address
First Line	:	14785 OLD SAINT AUGUSTINE RD STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-7407
Country	:	US
Telephone Number	:	904-456-0017
Fax Number	:	904-456-0018

Provider Business Practice Location Address
First Line	:	14785 OLD SAINT AUGUSTINE RD STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-7407
Country	:	US
Telephone Number	:	904-456-0017
Fax Number	:	904-456-0018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	03/13/2025

Similar Medicare Providers

1700847084 — JON F. GRAHAM MD
Practice Location Address:

14785 OLD SAINT AUGUSTINE RD STE 100
JACKSONVILLE, FL
32258-7407

Practice Phone: 904-456-0017
Practice Fax: 904-456-0018

1518441153 — BROOKE E WOODALL OTR/L
Practice Location Address:

14785 OLD SAINT AUGUSTINE RD STE 100
JACKSONVILLE, FL
32258-7407

Practice Phone: 904-292-1808
Practice Fax:

1801457296 — INTEGRITY SPINE AND ORTHOPEDICS LLC
Practice Location Address:

14785 OLD SAINT AUGUSTINE RD STE 100
JACKSONVILLE, FL
32258-7407

Practice Phone: 904-456-0017
Practice Fax: 904-456-0018

1073613295 — DR. NATHAN PERRY JR. M.D.
Practice Location Address:

1301 MONUMENT RD , SUITE 21
JACKSONVILLE, FL
32225-7407

Practice Phone: 904-724-9334
Practice Fax: 904-725-3120

1891844130 — JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Practice Location Address:

1301 MONUMENT RD STE 14&15
JACKSONVILLE, FL
32225-7407

Practice Phone: 904-733-9948
Practice Fax: 904-733-9984

1629375456 — LINDA M ROWAN ARNP
Practice Location Address:

1301 MONUMENT RD , STE 19
JACKSONVILLE, FL
32225-7407

Practice Phone: 904-727-5160
Practice Fax:

Directions to “ ANTHONY ATWOOD PREMO APRN, AGACNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.