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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

NPI # 1326498676
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
FL License # ME116882
FL License # ME129977
FL Medicaid 021709600
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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