Organization Active NPI

Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Homestead, FL
National Provider Identifier
1730757493
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CONVIVA MEDICAL CENTER MANAGEMENT LLC
Practice address
692 N Homestead Blvd Ste 102
Homestead, FL 33030-6236
Phone
(786) 243-5900
Fax
(855) 451-2158
NPI assigned
Jun 17, 2021
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CONVIVA MEDICAL CENTER MANAGEMENT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

692 N Homestead Blvd Ste 102
Homestead, FL 33030-6236

Mailing address

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

Other names 1

  • Conviva North Homestead Other name

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
10D1004274Conviva Medical Center Management, LLC692 N Homestead Boulevard, Ste 102, Homestead, FL 33030Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Conviva Med Ctr MGMT LLC76 organizations share this tax ID, including this one
Part of
Conviva Med Ctr MGMT LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

650 N Homestead Blvd
Homestead, FL 33030
Phone (786) 243-5900

692 N Homestead Blvd
Ste 102
Homestead, FL 33030
Phone (305) 664-0067

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1730757493",
    "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": "692 N HOMESTEAD BLVD STE 102",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330306236",
            "telephone_number": "786-243-5900",
            "fax_number": "855-451-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVIVA MEDICAL CENTER MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONVIVA MEDICAL CENTER MANAGEMENT LLC",
        "enumeration_date": "2021-06-17",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "MERIWETHER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-500-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conviva North Homestead",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Conviva North Homestead",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.