Provider Demographics
NPI:1801349121
Name:ANUVIA MEDICAL CENTER
Entity type:Organization
Organization Name:ANUVIA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-201-3794
Mailing Address - Street 1:190 NE 199TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2927
Mailing Address - Country:US
Mailing Address - Phone:786-589-7840
Mailing Address - Fax:305-391-3551
Practice Address - Street 1:190 NE 199TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2927
Practice Address - Country:US
Practice Address - Phone:786-589-7840
Practice Address - Fax:305-391-3551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 363LF0000X
FLARNP9335724261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty