| Conviva Medical Center Management Llc | |
|
1215 S 25th St Fort Pierce FL 34947-4702 | |
| (772) 837-6918 | |
| Not Available |
| Full Name | Conviva Medical Center Management Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1215 S 25th St, Fort Pierce, 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 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Conviva Medical Center Management Llc 1215 S 25th St Fort Pierce FL 34947-4702 Ph: (772) 837-6918 |
| NPI Number | 1104688548 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 01/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104688548 | 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 |
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