Individual provider Active NPI

Jorge Enrique Izquierdo Paz

  • Nurse Practitioner
  • Doral, FL
National Provider Identifier
1710839840
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11045005 Issued in FL
Practice address
3901 NW 79TH Ave
Doral, FL 33166-6508
Phone
(305) 400-4605
Fax
(866) 611-2870
NPI assigned
Feb 11, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X APRN11045005 FL Primary

Addresses

Primary practice location

3901 NW 79TH Ave
Doral, FL 33166-6508

Mailing address

4353 NW 77TH Ave FL 3
Miami, FL 33166-6736
Phone (305) 204-0333

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
I20260601000228 FL Practitioner - Nurse Practitioner 5395215362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4353 NW 77TH Ave
FL 3
Miami, FL 33166-6736

7797 W 29TH LN
Apt 201
Hialeah, FL 33018-5189

7797 W 29TH LN Apt
Suite 201
Hialeah, FL 33018-5189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11045005FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Univida Medical Center LLC Single Specialty CurrentSince May 1, 2026 Accepting new patients

Locations

3901 NW 79th Ave
Ste 104
Doral, FL 33166
Phone (305) 400-4605

4353 NW 77th Ave
Fl 3
Miami, FL 33166
Phone (302) 204-0333

6400 SW 8th St
West Miami, FL 33144
Phone (305) 239-2515

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": "1770768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1710839840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 NW 77TH AVE FL 3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331666736",
            "telephone_number": "305-204-0333",
            "fax_number": "305-359-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666508",
            "telephone_number": "305-400-4605",
            "fax_number": "866-611-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO PAZ",
        "first_name": "JORGE",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11045005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.