PROVIDENCE COMMUNITY CENTER LLC
NPI 1457760712
Nurse Practitioner - Family in Miami, FL
About Providence Community Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE COMMUNITY CENTER LLC (NPI 1457760712) is a healthcare organization registered as a family in Miami, Florida and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through May 7, 2027 and lists Julina T Dorval, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Providence Community Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Providence Community Center LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 10D2095640
Providence Community Center LLC · Miami, FLFrequently 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 Providence Community Center LLC's NPI number?
The NPI number for Providence Community Center LLC is 1457760712. It was assigned to this organization in the NPPES registry on August 11, 2014.
Where is Providence Community Center LLC located?
Providence Community Center LLC is located at 5932 NE 2nd Ave, Miami, FL 33137. The listed phone number is (786) 546-5129.
What is Providence Community Center LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Providence Community Center LLC enrolled in Medicare?
Yes. Providence Community Center LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Providence Community Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Providence Community Center LLC, in General Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Providence Community Center LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2095640) is associated with this NPI, valid through May 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Providence Community Center LLC accept?
Health plans from Molina Healthcare and Wellpoint list Providence Community Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Providence Community Center LLC was last updated on August 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.
# Providence Community Center Llc · NPI 1457760712
Family organization in Miami, Florida. Organization record, active in the CMS NPPES registry since August 11, 2014.
## Identity
- **NPI:** 1457760712 (Entity type: Organization)
- **Enumerated:** August 11, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Julina Dorval, MANAGING MEMBER
## Practice location
- **Address:** 5932 NE 2ND AVE, Miami, FL 33137-2010
- **Phone:** (786) 546-5129 · **Fax:** (954) 241-6117
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), General Practice (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 11, 2014
- **Other identifiers:** Medicare PIN GN339 (FL)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1457760712) · Data from the CMS NPPES public registry.