CONVIVA SPECIALTY, LLC (NPI# 1326498676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326498676 |
| Entity Type | Organization |
| Organization Name | CONVIVA SPECIALTY, LLC |
| Practice Address |
12905 Sw 42nd St Ste 103 Miami FL 33175-2910 |
| Mailing Address |
6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 |
| Practice Telephone | 7868015620 |
| Mailing Telephone | 3055002000 |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | GEMMA ROSELLO (VP) |
| Authorized Official Telephone | 3055002000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | ME116882 | FL | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | ME129977 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 021709600 | 05 |
| Street Address |
12905 SW 42ND ST STE 103 |
| City | MIAMI |
| State | FL |
| Zip Code | 33175-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885965 | Kevin Bernardo Gonzalez | Behavior Technician | 11895 Sw 37 St, Miami, FL 33175 | 2020-06-11 |
| 1619509106 | Gladysbel Lorenzo | Nurse Practitioner | 11740 Sw 42st, Miami, FL 33175 | 2020-02-12 |
| 1154885200 | Vanessa Arzola Dmd Pa and Associates | Clinic/Center | 13419 Sw 56th Street, Miami, Miami, FL 33175 | 2019-01-23 |
| 1588145932 | Mailen Gonzalez | Nurse Practitioner | 12294 Sw 29 Ter, Miami, FL 33175 | 2018-08-23 |
| 1639655350 | Carolina Marie Trueba | Behavior Technician | 12825 Sw 49th Terr, Miami, FL 33175 | 2018-07-16 |
| 1033611504 | Joan Coro | Behavior Technician | 12905 Sw 42nd St Suite 219, Miami, FL 33175 | 2018-03-01 |
| 1417456864 | Ignacio Alzugaray | Nurse Practitioner | 12317 Sw 20th Ter, Miami, FL 33175 | 2018-02-12 |
| 1215436993 | Desiree Rengifo-glasgow | Nurse Practitioner | 11865 Sw 26th St Ste J2, Miami, FL 33175 | 2018-02-07 |
| 1639678691 | Behavior Professional Consultants Corp. | Community/Behavioral Health | 2460 Sw 137th Ave 242, Miami, FL 33175 | 2018-02-06 |
| 1992204291 | Humberto Lorenzo Paez | Nurse Practitioner | 4205 Sw 136th Place, Miami, FL 33175 | 2018-02-02 |
| Find all providers in zip 33175 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114488400 | Cfl Care of Fl IIi, LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760, Miami, FL 33131-1815 | 2019-03-28 |
| 1427407410 | Dean Heller Md Pa | Internal Medicine | 9240 Sunset Dr Ste 116, Miami, FL 33173-3262 | 2016-06-09 |
| 1174970073 | Niberto A Moreno Md Pllc | Internal Medicine | 9195 Sw 72nd St Ste 200, Miami, FL 33173-3488 | 2016-05-20 |
| 1154782449 | Collaborative Cardiovascular, LLC | Internal Medicine | 11220 Sw 74th Ct, Miami, FL 33156-4520 | 2016-03-14 |
| 1295192086 | Ana M Acosta Md Pa | Internal Medicine | 330 Sw 27th Ave Ste 701, Miami, FL 33135-2968 | 2016-01-25 |
| 1851718951 | Mehrdad Ghahramani | Internal Medicine | 1320 Nw 14th St, Miami, FL 33125-1609 | 2014-03-26 |
| 1215287594 | Primary Provider Inc. | Internal Medicine | 9193 Sunset Dr Ste 210, Miami, FL 33173-3487 | 2012-09-14 |
| 1235494402 | Ricardo Javier Hernandez | Internal Medicine | 3641 S Miami Ave Ste 221, Miami, FL 33133-4219 | 2012-07-12 |
| 1215296199 | Casa De Corazon P A | Internal Medicine | 3661 S Miami Ave Ste 902, Miami, FL 33133-4214 | 2012-05-11 |
| 1457617516 | Marquand Patton Jr. | Internal Medicine | 2601 Sw 37th Ave Ste 901, Miami, FL 33133-2751 | 2012-04-03 |
| Find all providers in MIAMI | ||||
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| 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.