Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jimmy Dorival, APRN

Individual provider Surgical Assistant · NPI 1114372596

Jimmy Dorival, APRN is a Nurse Practitioner in Port St Lucie, Florida. Qualified in 2021, 5 years ago. Practices with Kopa LLC, a 39-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2016
Specialties on file
3
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

See every abbreviation used in this directory →

Practice location Address checks out

672 SW Prima Vista Blvd Ste 102
Port St Lucie, FL 34983-1820
Phone: (772) 905-2560
Fax: (772) 336-8341
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11019774 (FL)
Surgical Assistant Taxonomy 246ZC0007X · Licence 16-270 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 11019774 (FL)

Record details

NPI number1114372596
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorYes
NPI enumeratedMay 4, 2016
Last updated in NPPESNovember 17, 2022
Certification dateNovember 17, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Kopa Llc — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Port St Lucie