Provider Demographics
NPI:1861271421
Name:AVIVA HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:AVIVA HEALTH & WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:VENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-915-0437
Mailing Address - Street 1:801 NW 37TH AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3883
Mailing Address - Country:US
Mailing Address - Phone:305-915-0437
Mailing Address - Fax:786-743-5312
Practice Address - Street 1:801 NW 37TH AVE STE 216
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3883
Practice Address - Country:US
Practice Address - Phone:305-915-0437
Practice Address - Fax:786-743-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch