Provider Demographics
NPI:1093013237
Name:AVIVA HEALTHCARE INC.
Entity Type:Organization
Organization Name:AVIVA HEALTHCARE INC.
Other - Org Name:AVIVA HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRIDO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:407-343-0542
Mailing Address - Street 1:353 CYPRESS PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3326
Mailing Address - Country:US
Mailing Address - Phone:407-343-0542
Mailing Address - Fax:407-343-0553
Practice Address - Street 1:353 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3326
Practice Address - Country:US
Practice Address - Phone:407-343-0542
Practice Address - Fax:407-343-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-12
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103256261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFI618AMedicare UPIN