Teddy J Dorival

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001732-P.A. Issued in PR

Practice address

12600 NW 19TH Ave
Miami, FL 33167-2159

Phone

(305) 842-0171

NPI assigned

Jul 17, 2023

Last updated

Mar 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1417636549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 NW 19TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331672159",
            "telephone_number": "305-842-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 NW 19TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331672159",
            "telephone_number": "305-842-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIVAL",
        "first_name": "TEDDY",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PACN140",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "001732-P.A.",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noelle Dorgham, DO
• Doris Care Assist LLC
• Doris M. Dominguez, MSW,LCSW,PA
• Sara J Dorison, MD
• Stephy Mitchelle Dorival
• Dorlis Developmental & Speech Center, Inc.
• Laurence I Dorman, DPM
• Danilo Thales Dormeus, RRT
• Manuela Dormoy, APRN
• Brianna Doroger

• Medical Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.