Provider Demographics
NPI:1255827176
Name:CONVIVA CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CONVIVA CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MERIWETHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-662-5200
Mailing Address - Street 1:4960 SW 72ND AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5506
Mailing Address - Country:US
Mailing Address - Phone:305-662-5200
Mailing Address - Fax:786-515-9653
Practice Address - Street 1:4960 SW 72ND AVE STE 406
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5506
Practice Address - Country:US
Practice Address - Phone:305-662-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center