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Organization
PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC
Active
Organization
PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC
Active
Parent organization
PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC
Other names
Conviva Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC
Authorized official
GEMMA ROSELLO (VP)
(305) 500-2000
Entity
Organization
Contact information
Practice address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(305) 662-5200
(305) 284-7948
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012616300
—
FL
05
—
012616301
—
FL
05
—
012616302
—
FL
05
—
012616303
—
FL
Enumeration date
11/27/2007
Last updated
02/03/2020
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