MCCI GROUP HOLDINGS LLC (NPI# 1689147662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689147662 |
| Entity Type | Organization |
| Organization Name | MCCI GROUP HOLDINGS LLC |
| Other Organization Name | CONVIVA CARE CENTER |
| Practice Address |
17160 Royal Palm Blvd Ste 2 Weston FL 33326-2395 |
| Mailing Address |
551856 Us Highway Suite 108 Hilliard FL 32046 |
| Practice Telephone | 9547626440 |
| Practice Fax Number | 9543899871 |
| Mailing Telephone | 9048622482 |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-07-03 |
| Authorized Official Name | GEMMA ROSELLO (OFFICER) |
| Authorized Official Telephone | 3055002000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCCI GROUP HOLDINGS LLC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Conviva Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265905004 | Mcci Group Holdings LLC | Family Medicine | 551856 Us Highway, Suite 108, Hilliard, FL 32046 | 2019-01-04 |
| 1770056673 | Mcci Group Holdings LLC | Internal Medicine | 5317 W Atlantic Ave Ste 104, Delray Beach, FL 33484-8175 | 2019-01-03 |
| 1184197097 | Mcci Group Holdings LLC | Family Medicine | 5350 W Atlantic Ave Ste 100, Delray Beach, FL 33484-8112 | 2019-01-03 |
| 1083187827 | Mcci Group Holdings LLC | Family Medicine | 463646 Sr 200 West, Suite 12, Yulee, FL 32097 | 2019-01-04 |
| 1629541537 | Mcci Group Holdings LLC | Internal Medicine | 9121 N Military Trl Ste 111, Palm Beach Gardens, FL 33410-5985 | 2019-01-03 |
| 1932672748 | Mcci Group Holdings LLC | Internal Medicine | 7200 Normandy Blvd Ste 20, Jacksonville, FL 32205-6271 | 2019-01-03 |
| 1649743451 | Mcci Group Holdings LLC | Family Medicine | 25 University Blvd N, Jacksonville, FL 32211-7550 | 2019-01-03 |
| 1770056681 | Mcci Group Holdings LLC | Internal Medicine | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2019-01-03 |
| 1700359619 | Mcci Group Holdings LLC | Internal Medicine | 5849 Okeechobee Blvd Ste 301, West Palm Beach, FL 33417-4352 | 2019-01-03 |
| 1518430420 | Mcci Group Holdings LLC | Family Medicine | 11744 Beach Blvd Ste 107, Jacksonville, FL 32246-8476 | 2019-01-03 |
| Street Address |
17160 ROYAL PALM BLVD STE 2 |
| City | WESTON |
| State | FL |
| Zip Code | 33326-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497287841 | Liorge Dominguez | Internal Medicine | 17160 Royal Palm Blvd Ste 2, Weston, FL 33326-2395 | 2017-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739327 | Rosi Gimeno Therapy, Inc | Counselor | 304 Indian Trace, Suite 933, Weston, FL 33326 | 2020-10-28 |
| 1003425919 | Austin Lee Williams | Counselor | 1398 Sw 160th, Sunrise, FL 33326 | 2020-07-27 |
| 1467086272 | Myriam Taveras D.m.d P.a | Clinic/Center | 15810 West Sr 84, Sunrise, FL 33326 | 2020-03-02 |
| 1487288288 | Marcella Patino | Nurse Practitioner | 2300 North Commerce Parkway, Suite 313, Weston, FL 33326 | 2020-03-02 |
| 1194375451 | Heather Silversmith | Dietitian, Registered | 1875 North Corporate Lakes Blvd, Suite 300, Weston, FL 33326 | 2019-09-18 |
| 1669039285 | Jennifer Mann | Dietitian, Registered | 1647 Island Way, Weston, FL 33326 | 2019-05-20 |
| 1194283820 | Focused Home Health Agency, Inc. | Home Health | 2394 Weston Rd, Weston, FL 33326 | 2019-03-12 |
| 1083100796 | Comfort Medical Group, LLC | Durable Medical Equipment & Medical Supplies | 1398 Sw 160th Avenue, Suite 101, Sunrise, FL 33326 | 2018-07-05 |
| 1356839120 | Vision Optique II LLC | Optometrist | 2200 N Commerce Pkwy Ste 110, Weston, FL 33326 | 2018-04-27 |
| 1033654678 | Sirahaydee Pena-alcantara | Registered Nurse | 1571 Fairlake Trace Apt 1608, Weston, FL 33326 | 2017-01-05 |
| Find all providers in zip 33326 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1205398575 | Fonort.llc | Internal Medicine | 2300 N Commerce Pkwy Ste 113, Weston, FL 33326-3255 | 2019-04-04 |
| 1609367747 | Gerardo Minsal, Md Pa | Internal Medicine | 16720 Sapphire Springs, Weston, FL 33331 | 2018-05-24 |
| 1497287841 | Liorge Dominguez | Internal Medicine | 17160 Royal Palm Blvd Ste 2, Weston, FL 33326-2395 | 2017-04-03 |
| 1861847485 | Jose Alejandro Coba | Internal Medicine | 1065 Nandina Dr, Weston, FL 33327-2115 | 2016-05-02 |
| 1528472768 | Long Medical LLC | Internal Medicine | 1172 Falls Blvd, Weston, FL 33327-1722 | 2014-06-16 |
| 1407285042 | Bertram Grapin | Internal Medicine | 2552 Bay Pointe Dr, Weston, FL 33327-1421 | 2013-11-04 |
| 1346675030 | Warren Cohn | Internal Medicine | 5 Richmond Hill Rd, Weston, CT 06883-2031 | 2013-09-12 |
| 1407290554 | Lisa Susan Mattam | Internal Medicine | 521 Ranch Rd, Weston, FL 33326-1757 | 2013-04-19 |
| 1205114360 | Jose Elias Collado Peralta | Internal Medicine | 3623 San Simeon Cir, Weston, FL 33331-5044 | 2011-07-23 |
| 1780991257 | Kate F Tye | Internal Medicine | 56 Colpitts Road, Weston, MA 02493 | 2010-09-07 |
| Find all providers in WESTON | ||||
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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.