Individual provider Active NPI

Brenda Lizette Garcia Doris

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1104676238
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11031887 Issued in FL
Practice address
653 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-0411
NPI assigned
Mar 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11031887 FL Primary

Addresses

Primary practice location

653 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

4320 Ellipse Dr
Jacksonville, FL 32246-7448
Phone (904) 772-4945

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240528003059 FL Practitioner - Nurse Practitioner 2466894035 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

5191 1St Coast Tech Pkwy
Jacksonville, FL 32224-0609
Phone (904) 427-7399

6015 118TH St
Jacksonville, FL 32244-3703
Phone (604) 633-0610

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

655 W 8TH St
Jacksonville, FL 32209-6511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11031887FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Solutions Jacksonville LLC CurrentSince May 13, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

653 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3902

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

Interoperability endpoints

  • Direct secure messaging: bdoris723638@direct.shands.ufl.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1104676238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 ELLIPSE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467448",
            "telephone_number": "904-772-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIS",
        "first_name": "BRENDA",
        "middle_name": "LIZETTE GARCIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11031887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.