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Organization
MCCI LIFETIME OF AVENTURA LLC
Active
Organization
MCCI LIFETIME OF AVENTURA LLC
Active
Other names
Conviva Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
GEMMA ROSELLO (VP)
(305) 500-2000
Entity
Organization
Contact information
Practice address
21150 BISCAYNE BLVD STE 302, AVENTURA, FL 33180-1250
(305) 931-0504
(305) 931-0939
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
Enumeration date
02/09/2012
Last updated
02/03/2020
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