Organization Active NPI

Av Life and Health Insurance LLC Dba Univida Medical Center

  • Adult Medicine Physician
  • Hialeah, FL
National Provider Identifier
1336898774
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
AV LIFE AND HEALTH INSURANCE LLC DBA UNIVIDA MEDICAL CENTER
Practice address
7000 W 12TH Ave Ste 4
Hialeah, FL 33014-5154
Phone
(305) 510-6778
NPI assigned
Mar 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Ana Mesa
Title
President
Phone
(305) 510-6778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

7000 W 12TH Ave Ste 4
Hialeah, FL 33014-5154

Mailing address

7000 W 12TH Ave Ste 4
Hialeah, FL 33014-5154
Phone (305) 510-6778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220717000009 FL Part B Supplier - Clinic/Group Practice 5799166195 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2258446Av Life and Health Insurance LLC7000 W 12TH Ave Suite 4, Hialeah, FL 33014Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory

Locations

7000 W 12th Ave
Ste 4
Miami Gardens, FL 33014
Phone (305) 243-7070

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1336898774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W 12TH AVE STE 4",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330145154",
            "telephone_number": "305-510-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 W 12TH AVE STE 4",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330145154",
            "telephone_number": "305-510-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV LIFE AND HEALTH INSURANCE LLC DBA UNIVIDA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "MESA",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-510-6778",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.