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TEDDY J DORIVAL
NPI 1417636549
Physician Assistant - Medical in Miami, FL

Active since July 17, 2023
12600 NW 19TH AVE, MIAMI, FL 33167(305) 842-0171 Get Directions Write a Review

NPPES record last updated: March 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 6, 2026, Jul 17, 2023 (2 updates tracked since 2023).

About Teddy J Dorival NPPES

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

TEDDY J DORIVAL (NPI 1417636549) is an individual medical provider in Miami, Florida, licensed in Puerto Rico (001732-P.A.) and active in the NPI registry since July 2023.

NPPES Registry Identity

NPI1417636549
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameTEDDY J DORIVAL
Location Address12600 NW 19TH AVEMiami, FL 33167-2159
Mailing Address12600 Nw 19th AveMiami, FL 33167-2159 · (305) 842-0171
Phone(305) 842-0171
Sole ProprietorYes
Enumeration DateJuly 17, 2023
Last NPPES UpdateMarch 6, 20262 updates tracked since enumeration
NPPES CertifiedMarch 6, 2026
✔ NPI 1417636549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in PR · 001732-P.A.✔ Licensed in FL · PACN140✔ Licensed in AZ · 10019
12600 NW 19TH AVE, Miami, FL 33167
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teddy Dorival's NPI number?

The NPI number for Teddy Dorival is 1417636549. It was assigned to this individual provider in the NPPES registry on July 17, 2023.

Where is Teddy Dorival located?

Teddy Dorival practices at 12600 NW 19th Ave, Miami, FL 33167. The listed phone number is (305) 842-0171.

What is Teddy Dorival's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Teddy Dorival was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.