National Provider Identifier Database

CONVIVA SPECIALTY LLC
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

CONVIVA SPECIALTY, LLC
12905 SW 42ND ST STE 103
MIAMI, FL33175-2910
Phone: 786-801-5620
Fax:
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Gastroenterology 207RG0100X
Neurological Surgery 207T00000X
Obstetrics & Gynecology 207V00000X
Physical Medicine & Rehabilitation 208100000X

* Indicates primary specialty

NPI Profile & details for CONVIVA SPECIALTY, LLC

NPI Number 1326498676
Legal business name
LBN
CONVIVA SPECIALTY, LLC
Authorized official JESSICA BONETTI - (ASSOCIATE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 06/17/2016
Last updated 10/29/2025 - About 7 months ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: ME116882
  • FL License #: ME129977
  • FL Medicaid: 021709600

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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