Conviva Medical Center Management LLC
Internal Medicine in Lutz, FL. Organization (NPI-2).
NPI number1164096764
StatusActive
Last updated in NPPESNov 25, 2024
Details
- NPI
- 1164096764
- Entity type
- Organization (NPI-2)
- Legal business name
- Conviva Medical Center Management LLC
- Organization subpart
- Yes
- Enumeration date
- May 18, 2021
- Certification date
- Nov 25, 2024
- Last updated
- Nov 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 208D00000X | General Practice | – | – |
Other names
- Conviva Land O' Lakes (Other Name)
Practice location
1563 Land O Lakes BlvdLutz, FL 33549-2930
Phone 813-949-4224 · Fax 813-949-2809
Mailing address
6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168
Phone 305-500-2000
Authorized official
Kevin Meriwether
President
3055002000
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