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Contact Information

CONVIVA SPECIALTY, LLC
12905 SW 42ND ST STE 103
MIAMI, FL33175-2910
 Phone: 786-801-5620
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for CONVIVA SPECIALTY LLC · (Female)

NPI # 1326498676
Status Active
Credentials
Entity Individual
Enumeration date 06/17/2016
Last updated 10/29/2025 - About 7 months ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME116882
  • FL License # ME129977
  • FL Medicaid 021709600
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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