NPIMap

Organization Active NPI

Metcare of Florida, Inc

Doing business as Conviva Care Center

  • Internal Medicine Physician
  • Port Orange, FL
National Provider Identifier
1619433869
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
METCARE OF FLORIDA, INC
Doing business as
Conviva Care Center
Practice address
4090 S Ridgewood Ave
Port Orange, FL 32127-4501
Phone
(386) 761-0050
Fax
(386) 761-1167
NPI assigned
Feb 13, 2019
Last updated
Jun 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
METCARE OF FLORIDA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Kevin Meriwether
Title
Division President
Phone
(305) 500-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4090 S Ridgewood Ave
Port Orange, FL 32127-4501

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other names 1

  • Conviva Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100308000361 FL Part B Supplier - Clinic/Group Practice 9739265141 Receives reassigned benefits from 61 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wellington, FL; Stuart, FL; Royal Palm Beach, FL; Fort Pierce, FL; Port St Lucie, FL; Port Saint Lucie, FL; Okeechobee, FL; Lake Park, FL…

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Metcare of Boca Raton

Locations

10151 Entrprs Cntr Blvd
Ste 101
Boynton Beach, FL 33437
Phone (561) 732-2136

405 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 257-1626

250 Dixie Blvd
Ste 203
Delray Beach, FL 33444
Phone (561) 278-5615

1722 State Road 44
New Smyrna Beach, FL 32168
Phone (386) 427-0390

210 NE 19th Dr
Ste 5
Okeechobee, FL 34972
Phone (863) 763-6431

21 Hospital Dr
Ste 125
Palm Coast, FL 32164
Phone (386) 586-1705

301 NW 84th Ave
Ste 101
Plantation, FL 33324
Phone (954) 581-1900

900 SW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 877-3591

12953 Palms West Dr
Ste 102
Village of Wellington, FL 33470
Phone (561) 793-1713

1395 S State Road 7
Ste 300
West Palm Beach, FL 33414
Phone (561) 795-2878

1411 N Flagler Dr
Ste 6800
West Palm Beach, FL 33401
Phone (561) 659-4004

Practitioners & affiliated clinicians

Practitioners 103

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 103

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1619433869",
    "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": "4090 S RIDGEWOOD AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274501",
            "telephone_number": "386-761-0050",
            "fax_number": "386-761-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METCARE OF FLORIDA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METCARE OF FLORIDA, INC.",
        "enumeration_date": "2019-02-13",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "MERIWETHER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIVISION PRESIDENT",
        "authorized_official_telephone_number": "305-500-2000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE 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"
        },
        {
            "organization_name": "Conviva Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.