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General NPI Number Information
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NPI Number | 1700375052
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Entity Type | Individual
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Provider Name | DORISLEY TRAVIESO JORGE ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 19001 SW 106TH AVE
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City | CUTLER BAY
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State | FL
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Zip | 33157-7669
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Country | US
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Telephone | 305-255-9806
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Fax | 305-255-9807
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Provider Business Mailing Address
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Address Line | 6423 SW 162ND AVE
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City | MIAMI
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State | FL
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Zip | 33193-5833
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Country | US
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Telephone | 305-766-4845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 9402632
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9402632
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | ARNP9402632
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9402632
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License Number State | FL
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