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PROVENA CARE LLC
NPI 1124840962
Clinic/Center - Primary Care in Miami, FL

Active since October 31, 2024CLIA 10D2336459 · Waiver
10251 SW 72ND ST STE 106, MIAMI, FL 33173(305) 230-7371(305) 428-3680 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 24, 2025, Nov 19, 2025 (2 updates tracked since 2025).

About Provena Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENA CARE LLC (NPI 1124840962) is a healthcare organization registered as a primary care in Miami, Florida and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through January 4, 2028 and lists Hector Fernandez, Administrator, as its authorized official.

NPPES Registry Identity

NPI1124840962
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROVENA CARE LLC
Location Address10251 SW 72ND ST STE 106Miami, FL 33173-2957
Mailing Address10251 Sw 72nd St Ste 106Miami, FL 33173-2957 · (305) 395-7108 · Fax (305) 428-3680
Phone(305) 230-7371
Fax(305) 428-3680
Organization SubpartNo
Authorized OfficialHector FernandezAdministrator · (305) 230-7371
Enumeration DateOctober 31, 2024
Last NPPES UpdateNovember 24, 20252 updates tracked since enumeration
NPPES CertifiedNovember 24, 2025
✔ NPI 1124840962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
10251 SW 72ND ST STE 106, Miami, FL 33173
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2336459

Provena Care LLC · Miami, FL
Active · expires Jan 4, 2028
CLIA Number10D2336459
Laboratory TypePhysician Office
Certificate Effective DateJanuary 5, 2026
Certificate Expiration DateJanuary 4, 2028
Laboratory DirectorSergio Jaramillo
Laboratory Phone(305) 395-7108
Laboratory LocationProvena Care LLC10251 SW 72 St Ste 106, Miami, FL 33173
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROVENA MEDEQUIP LLC
Durable Medical Equipment & Medical Supplies
10251 SW 72ND ST STE 106
MIAMI, FL 33173
Miami-Dade County (305) 602-5525
HEALTH 365, LLC
Clinic/Center (Primary Care)
10251 SW 72ND ST STE 106
MIAMI, FL 33173
Miami-Dade County (786) 469-2730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provena Care LLC's NPI number?

The NPI number for Provena Care LLC is 1124840962. It was assigned to this organization in the NPPES registry on October 31, 2024.

Where is Provena Care LLC located?

Provena Care LLC is located at 10251 SW 72nd St Ste 106, Miami, FL 33173. The listed phone number is (305) 230-7371.

What is Provena Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Provena Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2336459) is associated with this NPI, valid through January 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Provena Care LLC was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.