Healthcare Provider Details

I. General information

NPI: 1316914849
Provider Name (Legal Business Name): JAIRO BRIEVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAIRO ALVAREZ BRIEVA M.D.

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14011 BEACH BLVD STE 120
JACKSONVILLE FL
32250-1695
US

IV. Provider business mailing address

705 WELLS RD STE 300
ORANGE PARK FL
32073-2982
US

V. Phone/Fax

Practice location:
  • Phone: 904-223-6400
  • Fax: 904-223-6420
Mailing address:
  • Phone: 904-282-6331
  • Fax: 904-866-4818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME77775
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: