Provider Demographics
NPI:1316914849
Name:BRIEVA, JAIRO (MD)
Entity type:Individual
Prefix:DR
First Name:JAIRO
Middle Name:
Last Name:BRIEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAIRO
Other - Middle Name:ALVAREZ
Other - Last Name:BRIEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:705 WELLS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-2982
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-866-4818
Practice Address - Street 1:14011 BEACH BLVD STE 120
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-1695
Practice Address - Country:US
Practice Address - Phone:904-223-6400
Practice Address - Fax:904-223-6420
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000962222AMedicaid
FL2570378-00Medicaid
FL080189982Medicare PIN
FL2570378-00Medicaid
FL46701VMedicare PIN