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Organization
CONVIDA MEDICAL SERVICES L.L.C.
Active
Organization
CONVIDA MEDICAL SERVICES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE MACIAS-RODRIGUEZ LPN (CEO)
(954) 549-5863
Entity
Organization
Contact information
Practice address
12030 SW 129TH CT STE 203, MIAMI, FL 33186-4584
(954) 549-5863
Mailing address
12030 SW 129TH CT STE 203, MIAMI, FL 33186-4584
(954) 549-5863
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
02/07/2023
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