MCCI GROUP HOLDINGS LLC (NPI# 1649743451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649743451 |
| Entity Type | Organization |
| Organization Name | MCCI GROUP HOLDINGS LLC |
| Other Organization Name | CONVIVA CARE CENTER |
| Practice Address |
25 University Blvd N Jacksonville FL 32211-7550 |
| Mailing Address |
6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 |
| Practice Telephone | 9049003667 |
| Practice Fax Number | 9049003278 |
| Mailing Telephone | 3055002000 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-07-03 |
| Authorized Official Name | 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 |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 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 |
| 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 |
| 1578036489 | Mcci Group Holdings LLC | Internal Medicine | 1786 Blanding Blvd Ste 3, Middleburg, FL 32068-3804 | 2019-01-03 |
| Street Address |
25 UNIVERSITY BLVD N |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32211-7550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306607 | Heber J Rosa | Family Medicine | 25 University Blvd N, Jacksonville, FL 32211-7550 | 2005-06-19 |
| 1316245418 | Kim M Brew | Nurse Practitioner | 25 University Blvd N, Jacksonville, FL 32211-7550 | 2011-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1366089641 | Prophetic Healing Deliverance Ministry of Mysteries, Inc | Counselor | 8550-2 Lone Star Road, Jacksonville, FL 32211 | 2019-12-05 |
| 1922656370 | Timothy Richard Barron | Behavior Technician | 5633 Clifton Ln, Jacksonville, FL 32211 | 2019-08-29 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1902397276 | Chandra Harris Washington | In Home Supportive Care | 2712 Gaillardia Rd, Jacksonville, FL 32211 | 2018-05-22 |
| 1043730062 | Monica R Iskander | Dentist | 465 University Blvd N, Jacksonville, FL 32211 | 2017-06-21 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| Find all providers in zip 32211 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676186 | Sarah Colleen Tapscott | Family Medicine | 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 | 2020-07-20 |
| 1790303170 | Samantha L Scott | Family Medicine | 516 Pierce Ln, Jacksonville, TX 75766-4546 | 2020-07-11 |
| 1689298689 | Meridian Spine and Joint, Inc | Family Medicine | 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 | 2020-06-04 |
| 1154942563 | Families First Medical Group | Family Medicine | 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 | 2020-04-27 |
| 1598396392 | Pareto Population Health Management Practice Pllc | Family Medicine | 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 | 2020-01-30 |
| 1942862206 | Cindy S Wright Do Pllc | Family Medicine | 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 | 2019-07-07 |
| 1942868377 | Pain Spine & Wellness LLC | Family Medicine | 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 | 2019-05-31 |
| 1669035705 | Kathy Jo Daniels | Family Medicine | 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 | 2019-04-15 |
| 1821579103 | Tiffany N Major | Family Medicine | 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 | 2018-08-24 |
| 1568987360 | Main Street Health LLC | Family Medicine | 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 | 2017-08-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32211 |
Please comment or provide details below to improve the information on MCCI GROUP HOLDINGS LLC.
| 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.