Active NPI
Jacqueline Garavito, M.D.
- Pediatrics Physician
- Bradenton, FL
National Provider Identifier
1770015117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME146653
- Practice address
- 1515 26TH Ave E
Bradenton, FL 34208-7707 - Phone
- (994) 170-8860
- NPI assigned
- Apr 3, 2017
- Last updated
- Oct 4, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME146653 | FL | Primary |
Addresses
Primary practice location
1515 26TH Ave E
Bradenton, FL 34208-7707
Mailing address
101 Riverfront Blvd Ste 710
Bradenton, FL 34205-8812
Phone (941) 776-4000
Other practice location 1
619 N Cove Blvd
Panama City, FL 32401-3642
Phone (786) 399-3395
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federico a. Frias MD PA | Pediatrics | Past | Accepting new patients |
| Federico a. Frias MD PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jacqueline.garavito.2@11352.direct.athenahealth.com
Organizations & group practices 2
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": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1770015117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 RIVERFRONT BLVD STE 710",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058812",
"telephone_number": "941-776-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 26TH AVE E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342087707",
"telephone_number": "994-170-8860"
}
],
"practiceLocations": [
{
"address_1": "619 N Cove Blvd",
"address_purpose": "LOCATION",
"city": "Panama City",
"state": "FL",
"postal_code": "324013642",
"country_code": "US",
"telephone_number": "786-399-3395",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARAVITO",
"first_name": "JACQUELINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-03",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME146653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.