Healthcare Provider Details

I. General information

NPI: 1215823794
Provider Name (Legal Business Name): VIVA RHEUMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 103
NAPLES FL
34109-0446
US

IV. Provider business mailing address

1855 VETERANS PARK DR STE 103
NAPLES FL
34109-0446
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-5220
  • Fax: 239-596-5222
Mailing address:
  • Phone: 239-596-5220
  • Fax: 239-596-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHI GARRETT
Title or Position: EVP
Credential:
Phone: 561-699-7101