Individual
DR. COURTNEY B FAHNHORST VIDRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
205 TRINITY WAY, SAINT JOHNS, FL 32259-1155
(904) 410-6040
Mailing address
101 MARKETSIDE AVE STE 404, PONTE VEDRA, FL 32081-1542
(904) 410-6040
(904) 914-9293
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
ME118350
FL
207Q00000X
Family Medicine Physician
Primary
85566
GA
207Q00000X
Family Medicine Physician
ME118350
FL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
ME118350
FL
208M00000X
Hospitalist Physician
ME118350
FL
Other
Enumeration date
06/27/2011
Last updated
10/13/2025
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