Individual provider Active NPI

Dorisley Travieso Jorge, ARNP

  • Family Nurse Practitioner
  • Cutler Bay, FL
National Provider Identifier
1700375052
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9402632 Issued in FL
Practice address
19001 SW 106TH Ave
Cutler Bay, FL 33157-7669
Phone
(305) 255-9806
Fax
(305) 255-9807
NPI assigned
May 2, 2018
Last updated
May 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9402632 FL
Family Nurse Practitioner 363LF0000X 9402632 FL Primary
Primary Care Nurse Practitioner 363LP2300X ARNP9402632 FL
General Practice Registered Nurse 163WG0000X 9402632 FL

Addresses

Primary practice location

19001 SW 106TH Ave
Cutler Bay, FL 33157-7669

Mailing address

6423 SW 162ND Ave
Miami, FL 33193-5833
Phone (305) 766-4845

Other practice location 1

14732 SW 56th St
Miami, FL 33185-4041
Phone (786) 668-6396

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
I20181207002451 FL Practitioner - Nurse Practitioner 0143475442 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9402632FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City Care Doctors Inc CurrentSince May 3, 2019 Accepting new patients

Locations

14732 SW 56th St
Miami, FL 33185
Phone (786) 668-6396

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1700375052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6423 SW 162ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935833",
            "telephone_number": "305-766-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19001 SW 106TH AVE",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331577669",
            "telephone_number": "305-255-9806",
            "fax_number": "305-255-9807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14732 SW 56th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331854041",
            "country_code": "US",
            "telephone_number": "786-668-6396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIESO JORGE",
        "first_name": "DORISLEY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9402632",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9402632",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9402632",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "9402632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

Verify at the official NPI Registry.