Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Centerwell Senior Primary Care Fl Jv PLLC

Organization Family Medicine Physician · NPI 1104653310

Centerwell Senior Primary Care Fl Jv PLLC is a Family Medicine Physician in Jacksonville, Florida. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10991 San Jose Blvd # 100
Jacksonville, FL 32223-6675
Phone: (904) 839-1037
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1104653310
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care Fl Jv PLLC
Authorized official Angie Martinez — Senior Credentialing Professional · (407) 447-7120
Other names Conviva San Jose; Conviva San Jose
NPI enumeratedSeptember 19, 2024
Last updated in NPPESDecember 10, 2024
Certification dateDecember 10, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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