CENTERWELL SENIOR PRIMARY CARE FL JV PLLC
NPI 1821825043
Internal Medicine in Wesley Chapel, FL

Q: What is Centerwell Senior Primary Care Fl Jv PLLC's specialty?

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

Active since September 19, 2024CLIA 10D2321825 · Waiver

28516 STATE ROAD 54, WESLEY CHAPEL, FL 33543(407) 447-7120 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Centerwell Senior Primary Care Fl Jv Pllc NPPES

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

CENTERWELL SENIOR PRIMARY CARE FL JV PLLC (NPI 1821825043), doing business as Conviva Wiregrass, is a healthcare organization registered as an internal medicine in Wesley Chapel, Florida and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through April 9, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1821825043

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCENTERWELL SENIOR PRIMARY CARE FL JV PLLC

Location Address28516 STATE ROAD 54Wesley Chapel, FL 33543-3210

Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120 · Fax (407) 770-0661

Phone(407) 447-7120

Organization SubpartYes

Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120

Enumeration DateSeptember 19, 2024

NPPES CertifiedSeptember 19, 2024

✔ NPI 1821825043 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

28516 STATE ROAD 54, Wesley Chapel, FL 33543

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Other Names 1

Doing Business AsConviva Wiregrass

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 10D2321825

Centerwell Senior Primary Care Fl Jv PLLC Dba Conviva Senior Primary Care · Wesley Chapel, FL

Active · expires Apr 9, 2027

CLIA Number10D2321825

Laboratory TypePhysician Office

Certificate Effective DateApril 10, 2025

Certificate Expiration DateApril 9, 2027

Laboratory DirectorDr. Tabatha L. Rios

Laboratory Phone(813) 815-8391

Laboratory LocationCenterwell Senior Primary Care Fl Jv PLLC Dba Conviva Senior Primary Care28516 State Rd 54, Wesley Chapel, FL 33543

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.

STEPHANIE L WECHSLER APRN

Nurse Practitioner (Family)