Healthcare Provider Details

I. General information

NPI: 1861271421
Provider Name (Legal Business Name): AVIVA HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NW 37TH AVE STE 216
MIAMI FL
33125-3883
US

IV. Provider business mailing address

801 NW 37TH AVE STE 216
MIAMI FL
33125-3883
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-0437
  • Fax: 786-743-5312
Mailing address:
  • Phone: 305-915-0437
  • Fax: 786-743-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIET VENTO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-915-0437