Edilia M Vivanco, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME66826 Issued in FL

Practice address

11701 Mills Dr
Miami, FL 33183-4824

Phone

(305) 270-2700

Fax

(305) 644-3143

NPI assigned

Jun 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment NPD

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1477599561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 MILLS DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834824",
            "telephone_number": "305-270-2700",
            "fax_number": "305-644-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVANCO",
        "first_name": "EDILIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME66826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376367600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edilia.vivanco.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "11701 Mills Dr",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331834824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vivacare Transportation LLC
• Vivacore Physical Therapy, LLC
• Giselle Vivaldi, M.D.
• Vivalife, Inc.
• Vivamas Medical Center - Kendall, LLC
• Judith Vivanco, RBT-24-3227486
• Lellany Vivanco, SLP
• Madiana Vivar
• Claudia S Vivas-Fons
• Jennifer Vivas

• Internal Medicine Physician in Miami, FL
• Providers in Miami, 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 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.