Individual provider Active NPI

Jacqueline Jennifer Gourdet Dorvil, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1053085506
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1686 Issued in FL
Practice address
6269 NW 7TH Ave
Miami, FL 33150-4394
Phone
(786) 977-2944
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1686 FL Primary

Addresses

Primary practice location

6269 NW 7TH Ave
Miami, FL 33150-4394

Mailing address

6269 NW 7TH Ave
Miami, FL 33150-4394
Phone (786) 977-2944

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jacqueline.gourdet.dorvil.1@29601.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205000696 FL Practitioner - General Practice 8527505775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

6269 NW 7TH Ave
Miami, FL 33150-4394
Phone (305) 751-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1686FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Feb 17, 2025 Accepting new patients

Locations

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6269 NW 7th Ave
Miami, FL 33150
Phone (305) 751-2000

Interoperability endpoints

  • Direct secure messaging: jacqueline.gourdet.dorvil.1@29601.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1053085506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6269 NW 7TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331504394",
            "telephone_number": "786-977-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6269 NW 7TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331504394",
            "telephone_number": "786-977-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURDET DORVIL",
        "first_name": "JACQUELINE",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacqueline.gourdet.dorvil.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6269 NW 7th Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331504394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.