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Conviva Medical Center Management LLC

Organization Active NPI Internal Medicine Physician · Hallandale Beach, FL

NPI 1760065098 · NPPES record last updated May 22, 2024

Key facts

NPI
1760065098
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
CONVIVA MEDICAL CENTER MANAGEMENT LLC
Practice address
1740 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Phone
(954) 456-5533
Fax
(888) 204-4839
NPI assigned
May 4, 2021
Organization subpart
Yes
Parent organization (as reported)
CONVIVA MEDICAL CENTER MANAGEMENT LLC

Authorized official

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

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.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2089824Conviva Medical Center Management, LLC
1740 East Hallandale Beach Blvd, Hallandale Beach, FL 33009		Certificate of waiverJan 7, 2027

National Provider Directory

Tax ID family
Conviva Med Ctr MGMT LLC (76 organizations share this tax ID)
Part of
Conviva Med Ctr MGMT LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X

Addresses

Primary practice location

1740 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611

Mailing address

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

Other names

  • Conviva Hallandale Other name

Other providers in Hallandale Beach, FL

All providers in Hallandale Beach, FL · Internal Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.