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

Teddy J Dorival

Individual provider Medical Physician Assistant · NPI 1417636549

Teddy J Dorival is a Medical Physician Assistant in Miami, Florida. Practices as a sole proprietor. Licensed in Arizona, Florida and Puerto Rico.

Licensed in
AZ, FL, PR
In the registry since
2023
Specialties on file
3

Practice location Address checks out

12600 NW 19th Ave
Miami, FL 33167-2159
Phone: (305) 842-0171
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 001732-P.A. (PR)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PACN140 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 10019 (AZ)

Record details

NPI number1417636549
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 17, 2023
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026

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