CONVIVA LAKE PARK
NPI 1053058214
Internal Medicine in Lake Park, FL

Q: What is Conviva Medical Center Management LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since May 18, 2022CLIA 10D2214450 · Waiver

415 US HIGHWAY 1 STE D, LAKE PARK, FL 33403(561) 842-5900(561) 844-6037 Get Directions Write a Review

NPPES record last updated: May 20, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 6, 2022, May 18, 2022 (2 updates tracked since 2022).

On this page

About Conviva Lake Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONVIVA LAKE PARK (NPI 1053058214) is a healthcare organization registered as an internal medicine in Lake Park, Florida and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through February 22, 2027 and lists Kevin Meriwether, President, as its authorized official.

NPPES Registry Identity

NPI1053058214

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCONVIVA MEDICAL CENTER MANAGEMENT LLC

Location Address415 US HIGHWAY 1 STE DLake Park, FL 33403-3585

Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000

Phone(561) 842-5900

Fax(561) 844-6037

Organization SubpartYes

Authorized OfficialKevin MeriwetherPresident · (305) 500-2000

Enumeration DateMay 18, 2022

Last NPPES UpdateMay 20, 20242 updates tracked since enumeration

NPPES CertifiedMay 20, 2024

✔ NPI 1053058214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedGeneral PracticeTaxonomy 208D00000X

415 US HIGHWAY 1 STE D, Lake Park, FL 33403

Open in Google Maps ↗

Other Names 1

Other NameConviva Lake Park

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2214450

Conviva Medical Center Management, LLC Dba Conviva Care Center · Lake Park, FL

Active · expires Feb 22, 2027

CLIA Number10D2214450

Laboratory TypePhysician Office

Certificate Effective DateFebruary 23, 2025

Certificate Expiration DateFebruary 22, 2027

Laboratory DirectorDr. Noelle Stewart

Laboratory Phone(561) 881-6038

Laboratory LocationConviva Medical Center Management, LLC Dba Conviva Care Center415 Us Highway 1 Suite D, Lake Park, FL 33403

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALAN J MARCUS DO PA

Internal Medicine