Organization · NPI-2

Conviva Medical Center Management LLC

Internal Medicine · Pinellas Park, FL

NPI number1902586480
StatusActive
Last updated in NPPESJun 21, 2024

Details

NPI
1902586480
Entity type
Organization (NPI-2)
Legal business name
Conviva Medical Center Management LLC
Organization subpart
Yes
Enumeration date
Jul 20, 2023
Certification date
Jun 21, 2024
Last updated
Jun 21, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes
207Q00000X Family Medicine––
208D00000X General Practice––

Other names

  • Conviva Pinellas Park (Doing Business As)

Practice location

7322 Us Highway 19 N
Pinellas Park, FL 33781-4600

Phone 727-373-4401

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Phone 305-500-2000

Authorized official

Kevin Meriwether
Division President
3055002000

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