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CONVIVA CORAL RIDGE
NPI 1659088052
Internal Medicine in Fort Lauderdale, FL

Active since November 04, 2022CLIA 10D2158097 · Waiver
2020 NE 48TH CT, FORT LAUDERDALE, FL 33308(954) 637-1168(954) 568-1330 Get Directions Write a Review

NPPES record last updated: May 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Conviva Coral Ridge NPPES

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

CONVIVA CORAL RIDGE (NPI 1659088052) is a healthcare organization registered as an internal medicine in Fort Lauderdale, Florida and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through November 19, 2026 and lists Kevin Marie Meriwether, President, as its authorized official.

NPPES Registry Identity

NPI1659088052
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCONVIVA MEDICAL CENTER MANAGEMENT LLC
Location Address2020 NE 48TH CTFort Lauderdale, FL 33308-4522
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(954) 637-1168
Fax(954) 568-1330
Organization SubpartYes
Authorized OfficialKevin Marie MeriwetherPresident · (305) 500-2000
Enumeration DateNovember 4, 2022
Last NPPES UpdateMay 21, 2024
NPPES CertifiedMay 21, 2024
✔ NPI 1659088052 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
2020 NE 48TH CT, Fort Lauderdale, FL 33308
Open in Google Maps ↗

Other Names 1

Doing Business AsConviva Coral Ridge

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 10D2158097

Conviva Medical Center Management LLC Dba Conviva Care Center · Fort Lauderdale, FL
Active · expires Nov 19, 2026
CLIA Number10D2158097
Laboratory TypePhysician Office
Certificate Effective DateNovember 20, 2024
Certificate Expiration DateNovember 19, 2026
Laboratory DirectorGaston R. Moran Celayes
Laboratory Phone(954) 630-0311
Laboratory LocationConviva Medical Center Management LLC Dba Conviva Care Center2020 NE 48th Court, Fort Lauderdale, FL 33308
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 5

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

DR. RAYMOND LAKIN MD
Family Medicine
2020 NE 48TH CT
FT LAUDERDALE, FL 33308
Broward County (954) 751-4671
ARELIS PEREZ RODRIGUEZ MD
Family Medicine
2020 NE 48TH CT
FORT LAUDERDALE, FL 33308
Broward County (954) 491-1686
DR. DAVID MICHAEL PAUL MD
Family Medicine
2020 NE 48TH CT
FORT LAUDERDALE, FL 33308
Broward County (954) 564-0062
GASTON MORAN CELAYES M.D.
Internal Medicine
2020 NE 48TH CT
FORT LAUDERDALE, FL 33308
Broward County (954) 247-2168
DR. JANESSY VASQUEZ MD
Family Medicine
2020 NE 48TH CT
FT LAUDERDALE, FL 33308
Broward County (954) 751-4671

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 Conviva Medical Center Management LLC's NPI number?

The NPI number for Conviva Medical Center Management LLC is 1659088052. It was assigned to this organization in the NPPES registry on November 4, 2022. The provider is doing business as Conviva Coral Ridge.

Where is Conviva Medical Center Management LLC located?

Conviva Medical Center Management LLC is located at 2020 NE 48th Ct, Fort Lauderdale, FL 33308. The listed phone number is (954) 637-1168.

What is Conviva Medical Center Management LLC's specialty?

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

Does Conviva Medical Center Management LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2158097) is associated with this NPI, valid through November 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Conviva Medical Center Management LLC was last updated on May 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.