Jacquelin Vincent

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PACN96 Issued in FL

Practice address

1307 Crane Crest Way
Orlando, FL 32825-4419

Phone

(407) 241-9971

NPI assigned

Jul 6, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1851743504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9919 CYPRESS KNEE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328259107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 CRANE CREST WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254419",
            "telephone_number": "407-241-9971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18404 N Tatum Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850321511",
            "country_code": "US",
            "telephone_number": "407-241-9971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "JACQUELIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-06",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10098",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PACN96",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10098",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SURGICAL ASSISTANT",
            "identifier": "246ZC0007X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PACN96",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Justine Vincent
• Craig R. Vincent, M.D.
• Davine A Vincent, BHS, MHS
• Genevieve Vincent
• Glynn Suzanne Vincent, LMHC 27498
• Luke Vincent, MD
• Sherling Vincent
• Tami S Vincent, RD, LD/N
• Augusto Vinces-Trelles
• Kacee Rebecca Vincett

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.