CONVIVA FORT PIERCE - NPI 1104688548 - Internal Medicine in Fort Pierce, 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.

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About Conviva Fort Pierce NPPES

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

CONVIVA FORT PIERCE (NPI 1104688548) is a healthcare organization registered as an internal medicine in Fort Pierce, Florida and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through March 17, 2027 and lists Kevin Meriwether, President, as its authorized official.

NPPES Registry Identity

NPI1104688548

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCONVIVA MEDICAL CENTER MANAGEMENT LLC

Location Address1215 S 25TH STFort Pierce, FL 34947-4702

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

Phone(772) 837-6918

Organization SubpartYes

Authorized OfficialKevin MeriwetherPresident · (305) 500-2000

Enumeration DateJanuary 30, 2024

Last NPPES UpdateMay 20, 2024

NPPES CertifiedMay 20, 2024

✔ NPI 1104688548 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

1215 S 25TH ST, Fort Pierce, FL 34947

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Other Names 1

Doing Business AsConviva Fort Pierce

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 10D2217097

Conviva Medical Center Management, LLC Dba Conviva Care Center · Fort Pierce, FL

Active · expires Mar 17, 2027

CLIA Number10D2217097

Laboratory TypePhysician Office

Certificate Effective DateMarch 18, 2025

Certificate Expiration DateMarch 17, 2027

Laboratory DirectorDiane Pugh

Laboratory Phone(772) 468-5925

Laboratory LocationConviva Medical Center Management, LLC Dba Conviva Care Center1215 S 25th St, Fort Pierce, FL 34947

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 7

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

DIANE L PUGH DO

Family Medicine