Conviva Medical Center Management LLC
Internal Medicine in Greenacres, FL. Organization (NPI-2).
NPI number1871167189
StatusActive
Last updated in NPPESJun 10, 2024
Details
- NPI
- 1871167189
- Entity type
- Organization (NPI-2)
- Legal business name
- Conviva Medical Center Management LLC
- Organization subpart
- Yes
- Enumeration date
- May 20, 2021
- Certification date
- Jun 10, 2024
- Last updated
- Jun 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 208D00000X | General Practice | – | – |
Other names
- Conviva Lake Worth (Other Name)
Practice location
5799 Lake Worth RdGreenacres, FL 33463-3207
Phone 561-967-0234 · Fax 561-439-4833
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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