DR. JACQUELINE JENNIFER GOURDET DORVIL MD
NPI 1053085506
General Practice in Miami, FL

Q: What is Jacqueline Gourdet Dorvil's NPI number?

The NPI number for Jacqueline Gourdet Dorvil is 1053085506. It was assigned to this individual provider in the NPPES registry on August 6, 2021.

Q: What is Jacqueline Gourdet Dorvil's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since August 06, 2021PECOS EnrolledAccepts Medicare Assignment

6269 NW 7TH AVE, MIAMI, FL 33150(786) 977-2944 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 10, 2025, Aug 7, 2024, Apr 25, 2024 and 1 more (4 updates tracked since 2021).

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About Dr. Jacqueline Jennifer Gourdet Dorvil Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE JENNIFER GOURDET DORVIL MD (NPI 1053085506) is an individual general practice provider in Miami, Florida, licensed in Florida (ACN1686) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1053085506

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameDR. JACQUELINE JENNIFER GOURDET DORVILCredential: MD

Location Address6269 NW 7TH AVEMiami, FL 33150-4394

Mailing Address6269 Nw 7th AveMiami, FL 33150-4394 · (786) 977-2944

Phone(786) 977-2944

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateAugust 6, 2021

Last NPPES UpdateFebruary 24, 20264 updates tracked since enumeration

NPPES CertifiedFebruary 24, 2026

✔ NPI 1053085506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in FL · ACN1686

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

6269 NW 7TH AVE, Miami, FL 33150

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacqueline Jennifer Gourdet Dorvil Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527505775

PECOS Enrollment IDI20250205000696

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Gourdet Dorvil reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Conviva Medical Center Management LLC

6.4 mi

Internal Medicine

6101 BLUE LAGOON DR STE 200
Miami, FL 33126

Reassigned Medicare billing, Florida enrollment
535 clinicians in this Medicare group

NPI 1649324278 (305) 500-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SENDY JEAN-LOUIS M.D.

Family Medicine