Graduated: 1982
NPI: 1003855354
Practice Locations (2)
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
2020 NE 48TH CT
FT LAUDERDALE, FL 333084522
9546300311
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
6221 N FEDERAL HWY
FT LAUDERDALE, FL 333081903
9544911686
Source: CMS National Downloadable File, September 2026.