MCCI GROUP HOLDINGS LLC (NPI# 1043780422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043780422 |
| Entity Type | Organization |
| Organization Name | MCCI GROUP HOLDINGS LLC |
| Other Organization Name | CONVIVA CARE CENTER |
| Practice Address |
9740 Sw 40th St Miami FL 33165-4080 |
| Mailing Address |
6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 |
| Practice Telephone | 3052275300 |
| Practice Fax Number | 3054853209 |
| Mailing Telephone | 3055002000 |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2019-07-03 |
| Authorized Official Name | MR. GEMMA ROSELLO (OFFICER) |
| Authorized Official Telephone | 3055002000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCCI GROUP HOLDINGS LLC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Conviva Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265905004 | Mcci Group Holdings LLC | Family Medicine | 551856 Us Highway, Suite 108, Hilliard, FL 32046 | 2019-01-04 |
| 1770056673 | Mcci Group Holdings LLC | Internal Medicine | 5317 W Atlantic Ave Ste 104, Delray Beach, FL 33484-8175 | 2019-01-03 |
| 1184197097 | Mcci Group Holdings LLC | Family Medicine | 5350 W Atlantic Ave Ste 100, Delray Beach, FL 33484-8112 | 2019-01-03 |
| 1083187827 | Mcci Group Holdings LLC | Family Medicine | 463646 Sr 200 West, Suite 12, Yulee, FL 32097 | 2019-01-04 |
| 1629541537 | Mcci Group Holdings LLC | Internal Medicine | 9121 N Military Trl Ste 111, Palm Beach Gardens, FL 33410-5985 | 2019-01-03 |
| 1932672748 | Mcci Group Holdings LLC | Internal Medicine | 7200 Normandy Blvd Ste 20, Jacksonville, FL 32205-6271 | 2019-01-03 |
| 1649743451 | Mcci Group Holdings LLC | Family Medicine | 25 University Blvd N, Jacksonville, FL 32211-7550 | 2019-01-03 |
| 1770056681 | Mcci Group Holdings LLC | Internal Medicine | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2019-01-03 |
| 1700359619 | Mcci Group Holdings LLC | Internal Medicine | 5849 Okeechobee Blvd Ste 301, West Palm Beach, FL 33417-4352 | 2019-01-03 |
| 1518430420 | Mcci Group Holdings LLC | Family Medicine | 11744 Beach Blvd Ste 107, Jacksonville, FL 32246-8476 | 2019-01-03 |
| Street Address |
9740 SW 40TH ST |
| City | MIAMI |
| State | FL |
| Zip Code | 33165-4080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649224205 | Oscar Saravia | Internal Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2006-05-19 |
| 1104384890 | Stephanie Tazi-sidqui | Nutritionist | 9740 Sw 40th St, Miami, FL 33165-4080 | 2019-03-12 |
| 1487919759 | William James Bonner | Physical Medicine & Rehabilitation | 9740 Sw 40th St, Miami, FL 33165-4080 | 2012-07-11 |
| 1689814493 | Sabas Ivan Gomez | Internal Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2009-03-06 |
| 1629221528 | Niberto Angel Moreno | Internal Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2008-10-23 |
| 1730367418 | Miguel A. Toyos | Nurse Practitioner | 9740 Sw 40th St, Miami, FL 33165-4080 | 2008-02-05 |
| 1023204104 | Elizabeth Mones | Family Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2007-09-21 |
| 1992991277 | Jacqueline Diaz | Family Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2007-09-19 |
| 1043410996 | Tersa Maria Solaun | Pharmacist | 9740 Sw 40th St, Miami, FL 33165-4080 | 2007-07-19 |
| 1174744478 | Bird Road Health Care, LLC | Internal Medicine | 9740 Sw 40th St, Miami, FL 33165-4080 | 2007-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292159 | Rosalyn Viaros | Student in an Organized Health Care Education/Training Program | 5220 Sw 115th Ave., Miami, FL 33165 | 2020-10-09 |
| 1801401500 | Paradigm Kids Miami LLC | Behavioral Analyst | 11375 Sw 45th St, Miami, FL 33165 | 2020-09-10 |
| 1922643972 | Maritza Suarez | Behavior Technician | 1811 Sw 107th Ave Apt 2301, Miami, FL 33165 | 2019-11-14 |
| 1700439700 | 305 Medical Care Inc | Physical Medicine & Rehabilitation | 8900 Sw 24th, #209, Miami, FL 33165 | 2019-07-18 |
| 1124682299 | Picasso Dental Miami, Inc | General Practice | 9230 Sw 40th St Ste A, Miami, FL 33165 | 2019-04-24 |
| 1538723838 | Mihr Urgent Care Corp | Clinic/Center | 8900 Sw 24 St. Ste #200, Miami, FL 33165 | 2019-04-23 |
| 1942766670 | Daniel Luis Hernandez | Nurse Practitioner | 10250 Sw 56 St Suit D-103, Miami, FL 33165 | 2019-02-19 |
| 1124583695 | Meliza Mercedes Perea | Nurse Practitioner | 3850 Sw 87th Ave Ste 205, Miami, FL 33165 | 2019-02-08 |
| 1629551700 | Jorge L Hernandez | Nurse Practitioner | 8710 Sw 41 Terrace, Miami, FL 33165 | 2018-09-13 |
| 1245718857 | Cac Florida Medical Centers, LLC | Clinic/Center | 10453-55 Sw 40 Street, Miami, FL 33165 | 2018-08-06 |
| Find all providers in zip 33165 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235756297 | Floridian Physicians | Internal Medicine | 4960 Sw 72nd Ave Ste 206, Miami, FL 33155-5549 | 2020-06-25 |
| 1437773918 | Elite Med Center Corp | Internal Medicine | 13155 Sw 134th St Ste 221, Miami, FL 33186-4489 | 2020-06-01 |
| 1841832359 | Haytham Elgammal | Internal Medicine | 7031 Sw 62nd, Miami, FL 33143 | 2019-10-16 |
| 1538714282 | Centrum Medical Holdings, LLC | Internal Medicine | 7600 Nw 19th St Ste 400, Miami, FL 33126-1219 | 2019-08-08 |
| 1659933182 | South Florida Healthcare Practitioners | Internal Medicine | 1040 Biscayne Blvd Apt 1506, Miami, FL 33132-1725 | 2019-07-04 |
| 1134781263 | Surgiclear | Internal Medicine | 1011 Ives Dairy Rd Ste 107, Miami, FL 33179-2536 | 2019-06-28 |
| 1811557523 | Luis Rene Velazquez | Internal Medicine | 8520 Sw 149th Ave Apt 1015, Miami, FL 33193-1446 | 2019-06-14 |
| 1881252088 | Miguel A Mujica-baella Md Pa | Internal Medicine | 15590 Sw 42nd Ln, Miami, FL 33185-4209 | 2019-06-03 |
| 1699249177 | Munia and Associates LLC | Internal Medicine | 9195 Sw 72nd St Ste 210, Miami, FL 33173-3488 | 2019-01-17 |
| 1174094361 | I.vizion | Internal Medicine | 7341 Nw 32nd Ave, Miami, FL 33147-5801 | 2018-12-16 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.