Individual
DR. EDILIA M VIVANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11701 MILLS DR, MIAMI, FL 33183-4824
(305) 270-2700
(305) 644-3143
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME66826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376367600
—
FL
Enumeration date
06/20/2006
Last updated
02/18/2026
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