Healthcare Provider Details

I. General information

NPI: 1538122247
Provider Name (Legal Business Name): VIVIANA SIRVEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 02/21/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 SW 117TH AVE STE 110
MIAMI FL
33183-4825
US

IV. Provider business mailing address

8200 SW 117TH AVE STE 110
MIAMI FL
33183-4825
US

V. Phone/Fax

Practice location:
  • Phone: 305-442-4116
  • Fax: 305-442-7282
Mailing address:
  • Phone: 305-442-4116
  • Fax: 305-442-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME84330
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD0084330
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME0084330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: