| Conviva Care Center | |
|
1233 Se Indian St Suite 103 Stuart FL 34997-5689 | |
| (772) 286-0552 | |
| (772) 286-7574 |
| Full Name | Conviva Care Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1233 Se Indian St, Stuart, Florida |
| Authorized Official Name and Position | Gemma Rosello (V.P. OPEARATIONS) |
| Authorized Official Contact | 3055002000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conviva Care Center 6101 Blue Lagoon Dr Suite 400 Miami FL 33126-2055 Ph: (305) 500-2114 | Conviva Care Center 1233 Se Indian St Suite 103 Stuart FL 34997-5689 Ph: (772) 286-0552 |
| NPI Number | 1679964555 |
|---|---|
| Provider Enumeration Date | 02/12/2015 |
| Last Update Date | 08/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679964555 | NPI | - | NPPES |
| CX415A | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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