Provider Demographics
NPI:1346787488
Name:METCARE OF FLORIDA INC
Entity Type:Organization
Organization Name:METCARE OF FLORIDA INC
Other - Org Name:CONVIVA CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-500-2109
Mailing Address - Street 1:6101 BLUE LAGOON DR
Mailing Address - Street 2:STE 400
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2055
Mailing Address - Country:US
Mailing Address - Phone:305-500-2114
Mailing Address - Fax:
Practice Address - Street 1:601 N CONGRESS AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4703
Practice Address - Country:US
Practice Address - Phone:561-272-1618
Practice Address - Fax:561-272-2800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METCARE OF FLORIDA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-27
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty