| NPI | 1942947346 |
|---|---|
| Other Name | CONVIVA SOUTH PEMBROKE |
| Entity Type | Organization |
| Authorized Contact | OFELIA BURGOS Credentialing Director 305-500-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-05-17 |