# JACQUELIN VINCENT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1851743504
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PACN96 | FL | Yes |
| 363AM0700X | Medical Physician Assistant | 10098 | AZ | — |

## Other

- **Enumeration date:** 07/06/2016
- **Last updated:** 11/25/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10098 | — | AZ |
| 01 | — | 246ZC0007X | FIRST SURGICAL ASSISTANT | FL |
| 05 | — | PACN96 | — | FL |