| NPI | 1114807476 |
|---|---|
| Doing Business As | CONVIVA SOUTH PEMBROKE |
| Entity Type | Organization |
| Authorized Contact | GEORGINA A COHEN Senior Credentialing Professional 305-500-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2025-09-05 |