MCCI GROUP HOLDINGS LLC (NPI# 1770056681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770056681 |
| Entity Type | Organization |
| Organization Name | MCCI GROUP HOLDINGS LLC |
| Other Organization Name | CONVIVA CARE CENTER |
| Practice Address |
5238-16 Norwood Ave Jacksonville FL 32208-5005 |
| Mailing Address |
551856 Us Highway Suite 108 Hilliard FL 32046 |
| Practice Telephone | 9048611222 |
| Practice Fax Number | 9048612688 |
| Mailing Telephone | 9048622482 |
| 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 | 207R00000X | Internal 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 |
| 1649743451 | Mcci Group Holdings LLC | Family Medicine | 25 University Blvd N, Jacksonville, FL 32211-7550 | 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 |
5238-16 NORWOOD AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548227226 | Michael J Fialho | Internal Medicine | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2006-04-27 |
| 1912380379 | Joselyn Arcelin | General Practice | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2015-07-02 |
| 1588075774 | Esau Laurencin | General Practice | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2014-05-11 |
| 1710274527 | Daniel Stanley Hutto | Nurse Practitioner | 5238-16 Norwood Ave, Jacksonville, FL 32208-5005 | 2011-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| 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 |
|---|---|---|---|---|
| 1760004329 | Colin Craig Rowell | Internal Medicine | 4500 San Pablo Rd S Fl 32, Jacksonville, FL 32224-1865 | 2020-05-17 |
| 1457982977 | Ateeque Khan, Md P.a. | Internal Medicine | 3659 Eastbury Dr, Jacksonville, FL 32224-1659 | 2020-02-03 |
| 1013478221 | Naji Maaliki | Internal Medicine | 653-1 W 8th St Fl L184, Jacksonville, FL 32209-6511 | 2019-03-29 |
| 1770043259 | Fadi Kandah | Internal Medicine | 653-1 W 8th St # L15, Jacksonville, FL 32209-6511 | 2019-03-21 |
| 1346696002 | Alana Akers | Internal Medicine | 203 Nacogdoches St Ste 290, Jacksonville, TX 75766-2444 | 2016-05-11 |
| 1346602927 | Kevin Roy Green | Internal Medicine | 653-1 W 8th St # L18, Jacksonville, FL 32209-6511 | 2016-03-23 |
| 1093175770 | Alex Balmir | Internal Medicine | 655 W 8th St # Cc262, Jacksonville, FL 32209-6511 | 2016-02-24 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1316338957 | Deep Patel | Internal Medicine | 5238 Norwood Ave Ste 16, Jacksonville, FL 32208-5005 | 2015-02-17 |
| 1063801934 | Avecina Medical | Internal Medicine | 9580 Applecross Rd, 106, Jacksonville, FL 32222-5845 | 2015-01-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
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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.