Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Fountain Family Medicine, PA

Organization Family Medicine Physician · NPI 1124228119

Fountain Family Medicine, PA provides Family Medicine Physician services in Jacksonville, Florida. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11701-32 San Jose Blvd Ste 103
Jacksonville, FL 32223 Not confirmed with CMS for 14 years — call before visiting
Phone: (904) 262-9075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1124228119
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leanne Macdonald — Office Manager · (904) 262-9075
NPI enumeratedJuly 19, 2007
Last updated in NPPESAugust 28, 2012
Mailing address11701-32 San Jose, Suite 103, Jacksonville, FL 32223

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