PROVIDENCE COMMUNITY CENTER LLC
NPI 1457760712
Nurse Practitioner - Family in Miami, FL

Q: 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.

Q: 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.

Active since August 11, 2014CLIA 10D2095640 · Waiver

5932 NE 2ND AVE, MIAMI, FL 33137(786) 546-5129(954) 241-6117 Get Directions Write a Review

NPPES record last updated: August 11, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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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

NPI1457760712

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NamePROVIDENCE COMMUNITY CENTER LLC

Location Address5932 NE 2ND AVEMiami, FL 33137-2010

Mailing Address5932 Ne 2nd AveMiami, FL 33137-2010 · (786) 546-5129 · Fax (954) 241-6117

Phone(786) 546-5129

Fax(954) 241-6117

Organization SubpartNo

Authorized OfficialJulina T DorvalManaging Member · (786) 546-5129

Enumeration DateAugust 11, 2014

✔ NPI 1457760712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · 3078052

Also ListedInternal MedicineTaxonomy 207R00000X · License ME94972 (FL)

5932 NE 2ND AVE, Miami, FL 33137

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Other Identifiers 1

Medicare PINGN339FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, Wellpoint.Insurance ›

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, FL

Active · expires May 7, 2027

CLIA Number10D2095640

Laboratory TypePhysician Office

Certificate Effective DateMay 8, 2025

Certificate Expiration DateMay 7, 2027

Laboratory DirectorAlphonse Giloux Dufreny

Laboratory Phone(305) 754-5131

Laboratory LocationProvidence Community Center LLC5932 NE 2nd Ave, Miami, FL 33137

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

JACKSON ETIENNE

Nurse Practitioner (Family)

5932 NE 2ND AVE
MIAMI, FL 33137

Miami-Dade County (954) 598-2364

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 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.

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.