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CONVIVA CARE CENTER
NPI 1619433869
Internal Medicine in Port Orange, FL

Active since February 13, 2019CLIA 10D2165204 · Waiver
4090 S RIDGEWOOD AVE, PORT ORANGE, FL 32127(386) 761-0050(386) 761-1167 Get Directions Write a Review

NPPES record last updated: June 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 21, 2024, Feb 13, 2019 (2 updates tracked since 2019).

About Conviva Care Center NPPES

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

CONVIVA CARE CENTER (NPI 1619433869) is a healthcare organization registered as an internal medicine in Port Orange, Florida and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Kevin Meriwether, Division President, as its authorized official.

NPPES Registry Identity

NPI1619433869
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMETCARE OF FLORIDA, INC
Location Address4090 S RIDGEWOOD AVEPort Orange, FL 32127-4501
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(386) 761-0050
Fax(386) 761-1167
Organization SubpartYesParent: Metcare Of Florida, Inc.
Authorized OfficialKevin MeriwetherDivision President · (305) 500-2000
Enumeration DateFebruary 13, 2019
Last NPPES UpdateJune 21, 20242 updates tracked since enumeration
NPPES CertifiedJune 21, 2024
✔ NPI 1619433869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
4090 S RIDGEWOOD AVE, Port Orange, FL 32127
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Other Names 1

Doing Business AsConviva Care Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE 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 10D2165204

Conviva Medical Center Management LLC Dba Conviva Care Center · Port Orange, FL
Active · expires Apr 22, 2027
CLIA Number10D2165204
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorDr. Therese Ibrahim
Laboratory Phone(386) 947-7966
Laboratory LocationConviva Medical Center Management LLC Dba Conviva Care Center4090 S Ridgewood Avenue, Port Orange, FL 32127
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.

MARGARET LEIGH ANN PECK ARNP, FNP-BC
Nurse Practitioner (Family)
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-0050
MRS. CASSANDRA NICHOLE WARNER APRN
Nurse Practitioner (Family)
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-0050
RACHAEL A HAMMEL NP
Nurse Practitioner (Family)
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-0050
AMER ZAKARIA
General Practice
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 387-5573
DR. DIANA E MENDEZ MD
Internal Medicine
4090 S RIDGEWOOD AVE
PT ORANGE, FL 32127
Volusia County (386) 761-0050
YARISNEISY GONZALEZ APRN
Nurse Practitioner (Family)
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 280-7251
DR. ENERCIDA MARTINEZ M.D
General Practice
4090 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-0050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Metcare Of Florida, Inc's NPI number?

The NPI number for Metcare Of Florida, Inc is 1619433869. It was assigned to this organization in the NPPES registry on February 13, 2019. The provider is doing business as Conviva Care Center.

Where is Metcare Of Florida, Inc located?

Metcare Of Florida, Inc is located at 4090 S Ridgewood Ave, Port Orange, FL 32127. The listed phone number is (386) 761-0050.

What is Metcare Of Florida, Inc's specialty?

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

Does Metcare Of Florida, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2165204) is associated with this NPI, valid through April 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Metcare Of Florida, Inc was last updated on June 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.