| Conviva Medical Center Management Llc | |
|
449621 Us Highway 301 Ste 110 Callahan FL 32011-9348 | |
| (904) 507-2692 | |
| (904) 507-2693 |
| Full Name | Conviva Medical Center Management Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 449621 Us Highway 301 Ste 110, Callahan, Florida |
| Authorized Official Name and Position | Ofelia Burgos (DIRECTOR) |
| Authorized Official Contact | 3055002000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conviva Medical Center Management Llc 6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 Ph: (305) 500-2000 | Conviva Medical Center Management Llc 449621 Us Highway 301 Ste 110 Callahan FL 32011-9348 Ph: (904) 507-2692 |
| NPI Number | 1336713676 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336713676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
Baptist Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45465 5th Ave, Callahan, FL 32011 Phone: 904-879-4544 Fax: 904-879-4411 |