Chiraly Dutrevil, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08240380 Issued in FL

Practice address

17206 Polo TRL
Lakewood Ranch, FL 34211-1720

Phone

(407) 219-1700

NPI assigned

Aug 19, 2024

Last updated

Aug 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Complexcare Medical Group Southeast H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1083508238

  FL, Single Specialty

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Single Specialty

  NPD
• Theoria Medical

  dba Theoria Primary Care

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946
  NPD (past)

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1992537955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17206 POLO TRL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342111720",
            "telephone_number": "407-219-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17206 POLO TRL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342111720",
            "telephone_number": "407-219-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTREVIL",
        "first_name": "CHIRALY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F08240380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geraldine Brooks Drexler, M.A., CCC-SP
• Mario Dube, D.O.M.
• Melanie Yvonne Scaggs Duenas
• Matthew William Duhaime, LCSW
• Jason Ross Duke, D.D.S
• Edens & Kaplan PL
• Brian Michael Edens, D.C.
• Sydney Edwards Froisland
• Jeanne Egan, OT
• Shacara Eggleston, MPAS, ATC, PA-C

• Family Nurse Practitioner in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.