Individual provider Active NPI

Bridgette J Kelley Dasilva, B.S.

  • Case Manager/Care Coordinator
  • Aventura, FL
National Provider Identifier
1346777067
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
K432070847710 Issued in FL
Practice address
20345 W Country Club Dr
PH 14
Aventura, FL 33180-1631
Phone
(305) 792-4931
Fax
(305) 466-2437
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X K432070847710 FL Primary

Addresses

Primary practice location

20345 W Country Club Dr
PH 14
Aventura, FL 33180-1631

Mailing address

20345 W Country Club Dr
PH 14
Aventura, FL 33180-1631
Phone (305) 792-4931

Other names 1

  • Bridgette J Kelley Former name

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
K432070847710FLMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1346777067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20345 W COUNTRY CLUB DR",
            "address_2": "PH 14",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801631",
            "telephone_number": "305-792-4931",
            "fax_number": "305-466-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20345 W COUNTRY CLUB DR",
            "address_2": "PH 14",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801631",
            "telephone_number": "305-792-4931",
            "fax_number": "305-466-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY DASILVA",
        "first_name": "BRIDGETTE",
        "middle_name": "J",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "K432070847710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "KELLEY",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.