McCi Lifetime of Aventura LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MCCI LIFETIME OF AVENTURA LLC

Practice address

21150 Biscayne Blvd Ste 302
Aventura, FL 33180-1250

Phone

(305) 931-0504

Fax

(305) 931-0939

NPI assigned

Feb 9, 2012

Organization subpart

No

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

Authorized official

Name

Gemma Rosello

Title

VP

Phone

(305) 500-2000

Specialties & licenses 1

Addresses

Other names 1

• Conviva Care Center Doing business as

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1437422284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21150 BISCAYNE BLVD STE 302",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801250",
            "telephone_number": "305-931-0504",
            "fax_number": "305-931-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCI LIFETIME OF AVENTURA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "ROSELLO",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "305-500-2000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conviva Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Maxwell
• Dennis Mazal, M.D.
• Aric W McBride, PHARMACIST
• Tamara O McCallum, D.D.S
• Brandon Wesley McCammon
• Kimberley Lentz McKenney, MD
• Margaret McKnight, PHYSICIAN ASSISTANT
• Mdtelepsychotherapy, LLC
• Medica Pharmacy & Compounding
• Medical Center of Winston Towers Inc

• Internal Medicine Physician in Aventura, FL
• Providers in Aventura, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.