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.
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 |
| NPI # | 1326498676 |
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| LBN Legal business name | CONVIVA SPECIALTY, LLC | ||||||||||||
| Authorized official | JESSICA BONETTI - (ASSOCIATE DIRECTOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 06/17/2016 | ||||||||||||
| Last updated | 10/29/2025 - About 7 months ago | ||||||||||||
| Identifiers |
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