NPIMap

Organization Active NPI

Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Tamarac, FL
National Provider Identifier
1972186401
Registry record updated Jun 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
7101 W McNab Rd Ste 101
Tamarac, FL 33321-5351
Phone
(954) 722-5600
Fax
(855) 252-2845
NPI assigned
May 3, 2021
Organization subpart
Yes
Parent organization
CONVIVA MEDICAL CENTER MANAGEMENT LLCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Kevin Meriwether
Title
Division 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) 16

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

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
10D0713975Conviva Medical Center Management, LLC7101 W McNab Rd Ste 101, Tamarac, FL 33321Certificate of waiverAug 31, 2026

National Provider Directory

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

Locations

7101 W McNab Rd
Ste 101
Tamarac, FL 33321
Phone (954) 722-5600

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

NPPES NPI Registry

Primary practice location

7101 W McNab Rd Ste 101
Tamarac, FL 33321-5351

Mailing address

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

Other names 1

NPPES NPI Registry
  • Conviva Starr Centre Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 21, 2024.

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1972186401",
    "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": "7101 W MCNAB RD STE 101",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333215351",
            "telephone_number": "954-722-5600",
            "fax_number": "855-252-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVIVA MEDICAL CENTER MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONVIVA MEDICAL CENTER MANAGEMENT LLC",
        "enumeration_date": "2021-05-03",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conviva Starr Centre",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Conviva Starr Centre",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tamarac, 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 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.