Active NPI
Jorge Gaviria, MD
- Surgery Physician
- Boca Raton, FL
National Provider Identifier
1770612855
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Aug 18, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME94318
- Practice address
- 2500 N Military TRL Ste 111
Boca Raton, FL 33431-6305 - Phone
- (561) 353-0330
- Fax
- (561) 353-0104
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME94318 | FL | Primary |
Addresses
Primary practice location
2500 N Military TRL Ste 111
Boca Raton, FL 33431-6305
Mailing address
2600 Lake Lucien Dr Ste 180
Maitland, FL 32751-7235
Phone (407) 875-2080
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME94318 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770612855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 LAKE LUCIEN DR STE 180",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517235",
"telephone_number": "407-875-2080",
"fax_number": "407-875-0518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N MILITARY TRL STE 111",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334316305",
"telephone_number": "561-353-0330",
"fax_number": "561-353-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIRIA",
"first_name": "JORGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME94318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.