Medical school: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1991
NPI: 1700854833
Practice Locations (2)
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
5238 -16 NORWOOD AVE
JACKSONVILLE, FL 322085005
9048611222
CONVIVA MEDICAL CENTER MANAGEMENT, LLC
3691 S CLYDE MORRIS BLVD
PORT ORANGE, FL 321292317
3866754411
Source: CMS National Downloadable File, September 2026.