Active NPI
Jairo Ernesto Riveros, LPN
- Licensed Practical Nurse
- Doral, FL
National Provider Identifier
1023407392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5164421
- Practice address
- 8019 Lake Dr Apt 204
Doral, FL 33166-7837 - Phone
- (786) 694-0880
- NPI assigned
- Jan 9, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5164421 | FL | Primary |
Addresses
Primary practice location
8019 Lake Dr Apt 204
Doral, FL 33166-7837
Mailing address
8019 Lake Dr Apt 204
Doral, FL 33166-7837
Phone (786) 694-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN5164421 | FL | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jairo Ernesto Riveros | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1538558895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1023407392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8019 LAKE DR APT 204",
"city": "DORAL",
"state": "FL",
"postal_code": "331667837",
"telephone_number": "786-694-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8019 LAKE DR APT 204",
"city": "DORAL",
"state": "FL",
"postal_code": "331667837",
"telephone_number": "786-694-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVEROS",
"first_name": "JAIRO",
"middle_name": "ERNESTO",
"name_prefix": "Mr.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-09",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5164421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.