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Individual
JIMMY DORIVAL
Active
Individual
JIMMY DORIVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
16-270
FL
363L00000X
Nurse Practitioner
11019774
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11019774
FL
Other
Enumeration date
05/04/2016
Last updated
11/17/2022
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