| NPI | 1053058214 |
|---|---|
| Other Name | CONVIVA LAKE PARK |
| Entity Type | Organization |
| Authorized Contact | KEVIN MERIWETHER President 305-500-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2024-05-20 |