Organization
EVIVIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONINA EREMENKO NP-C (CEO)
(786) 673-4029
Entity
Organization
Contact information
Practice address
1370 WASHINGTON AVE STE 224, MIAMI BEACH, FL 33139-4215
(786) 673-4029
Mailing address
1370 WASHINGTON AVE STE 224, MIAMI BEACH, FL 33139-4215
(786) 673-4029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
05/25/2020
Last updated
09/06/2021
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