Organization
PROVENA CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR FERNANDEZ (ADMINISTRATOR)
(305) 230-7371
Entity
Organization
Contact information
Practice address
10251 SW 72ND ST STE 106, MIAMI, FL 33173-2957
(305) 230-7371
(305) 428-3680
Mailing address
10251 SW 72ND ST STE 106, MIAMI, FL 33173-2957
(305) 395-7108
(305) 428-3680
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
11/24/2025
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