Provider Demographics
NPI:1538122247
Name:SIRVEN, VIVIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:
Last Name:SIRVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 SW 117TH AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4828
Mailing Address - Country:US
Mailing Address - Phone:305-442-4116
Mailing Address - Fax:305-442-7282
Practice Address - Street 1:8200 SW 117TH AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4824
Practice Address - Country:US
Practice Address - Phone:305-442-4116
Practice Address - Fax:305-442-7282
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84330174400000X
FLMD0084330207K00000X
FLME0084330207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264539400Medicaid
FL264539400Medicaid
FLH66346Medicare UPIN