MR. IVAN VIVANCO


Address: 9655 Nw 41st St, Doral, FL 33178-2973
Phone: 3054361563

MR. IVAN VIVANCO (NPI# 1114418878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114418878
Entity Type Individual
Full Name MR. IVAN VIVANCO
Credential APRN
Practice Address 9655 Nw 41st St
Doral
FL 33178-2973
Mailing Address 900 S Pine Island Rd Ste 800
Plantation
FL 33324-3923
Practice Telephone 3054361563
Practice Fax Number 3054361564
Mailing Telephone 3054361563
Mailing Fax Number 3054361564
Enumeration Date 2018-05-29
Last Update Date 2019-12-06
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
APRN9455497 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 104828000 05

Other Providers IVAN VIVANCO

NPI Name Taxonomy Address Enumeration
1700423712 Ivan Vivanco Rehabilitation Practitioner 21000 Plummer St, Chatsworth, CA 91311-4903 2019-12-09

Office Location

Street Address 9655 NW 41ST ST
City DORAL
State FL
Zip Code 33178-2973

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801882899 Victoria Helena Fierro-cobas Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2005-09-23
1285173708 Julio Triay Nurse Practitioner 9655 Nw 41st St, Doral, FL 33178-2973 2017-02-16
1720468341 Carolina Bautista Vallderuten Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2015-06-09
1992110985 Mayda Torres Colon Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2014-06-27
1598185217 Eduardo Ajuria Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2014-04-21
1972846913 Melanie Iglesias Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2013-03-28
1851647986 Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2012-07-26
1376849034 Gabriela Almeida Physician Assistant 9655 Nw 41st St, Doral, FL 33178-2973 2011-01-28
1134382922 Judy Villalobos Physician Assistant 9655 Nw 41st St, Doral, FL 33178-2973 2008-07-02
1760554422 Ana Maria Castaneda Pediatrics 9655 Nw 41st St, Doral, FL 33178-2973 2006-11-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518571801 The Velis Brothers Dental Team Dentist 10449 Nw 41 St., Doral, FL 33178 2020-09-03
1316598188 Marli Catturini Echegoyen Behavior Technician 8652 Nw 112th Ct, Doral, FL 33178 2019-09-24
1700343043 Matilde Lidia Lewis Registered Nurse 9915 Nw 41 St, Suite 230, Doral, FL 33178 2019-02-22
1700366622 Polyclinic Healthcare Corp Family Medicine 10800 Nw 58th St, Doral, FL 33178 2018-08-20
1689022691 Zeida M Prendes-guerra Behavioral Analyst 5620 Nw 107th Ave Apt 1512, Doral, FL 33178 2016-05-31
1437519014 Isel Gonzalez Nurse Practitioner 11573 Nw 69 Terr, Doral, FL 33178 2016-02-25
1114335189 Mia Mccarthy Student in an Organized Health Care Education/Training Program 10045 Nw 46th St, Doral, FL 33178 2014-07-23
1043641269 Ultimate Performance Fitness Consultants Pl Clinic/Center 9831 Nw 58th St #130, Doral, FL 33178 2013-12-13
1871924845 Silvana Newman Behavioral Analyst 8249 Nw 36th Street Suite 206, Miami, FL 33178 2013-12-02
1154755478 Dina Garabedian Physician Assistant 7952 Nw 114th Ct, Miami, FL 33178 2013-08-22
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255802997 Yoheli M Gutierrez Nurse Practitioner 7950 Nw 53rd St Ste 102, Doral, FL 33166-4681 2018-12-06
1730720335 Ana Laura Sanchez Villarreal Nurse Practitioner 7950 Nw 53rd St Ste 102, Doral, FL 33166-4681 2019-10-04
1073749750 Ana Maria Diaz Nurse Practitioner 10820 Nw 58th St, Doral, FL 33178-2854 2009-06-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1003417072 Carmen Moreno Nurse Practitioner 336 Golfview Rd Apt 909, North Palm Beach, FL 33408-3512 2020-11-05
1366043614 Christi Koshy Nurse Practitioner 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 2020-11-03
1730789322 Michelle Yen-vera Nurse Practitioner 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 2020-11-01
1376143487 Aimee N Jorgenson Stough Nurse Practitioner 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 2020-10-28
1588271233 Olivia Janelle De Jong Nurse Practitioner 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 2020-09-28
1801407796 Elisabeth Morley Chinlund Nurse Practitioner 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 2020-08-13
1972113025 Nicole Horn Nurse Practitioner 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 2020-08-04
1073131850 Olivia Dawn Wilson Nurse Practitioner 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 2020-07-08
1427687565 Cortney M Starr Nurse Practitioner 2261 Kingfisher Ln, Clearwater, FL 33762-3323 2020-04-01
1285263335 Summer Leigh Moran Nurse Practitioner 528 W Baldwin Rd # A, Panama City, FL 32405-3313 2020-04-01
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Competitor

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City DORAL
Zip Code 33178

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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