Healthcare Provider Details

I. General information

NPI: 1801349121
Provider Name (Legal Business Name): ANUVIA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 NE 199TH ST STE 102
MIAMI FL
33179-2927
US

IV. Provider business mailing address

190 NE 199TH ST STE 102
MIAMI FL
33179-2927
US

V. Phone/Fax

Practice location:
  • Phone: 786-589-7840
  • Fax: 305-391-3551
Mailing address:
  • Phone: 786-589-7840
  • Fax: 305-391-3551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberARNP9335724
License Number StateFL

VIII. Authorized Official

Name: VENISE DANDA
Title or Position: MEDICAL DIRECTOR
Credential: APRN
Phone: 786-201-3794