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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: July 19, 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.Information from the official NPPES registry record, last updated March 6, 2026.

NPPES Registry Identity

NPI1417636549
Entity TypeIndividualMale
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. How NPI validation works

★ Primary Specialty

Physician Assistant · Medical

Taxonomy 363AM0700X · Physician Assistants & Advanced Practice Nursing Providers

✔ 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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Also on File with NPPES

Group Practice1
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization. (193200000X MULTI-SPECIALTY GROUP)

Reviews for TEDDY J DORIVAL

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Frequently Asked Questions

What is Teddy Dorival's NPI number?

The NPI number assigned to this healthcare provider is 1417636549, enumerated as an "individual" on July 17, 2023.

Where is the provider located?

The provider is located at 12600 NW 19TH AVE MIAMI, FL 33167 and the phone number is (305) 842-0171.

What is the provider's specialty?

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.