NPIMap

Organization Active NPI

Juvensa LLC

  • Family Medicine Physician
  • Doral, FL
National Provider Identifier
1043900798
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JUVENSA LLC
Practice address
2500 NW 79TH Ave Ste 265
Doral, FL 33122-1088
Phone
(786) 504-4626
Fax
(305) 468-6217
NPI assigned
May 8, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anneyd Avalos PenaNPI 1962863266
Title
Owner
Phone
(786) 925-3143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2500 NW 79TH Ave Ste 265
Doral, FL 33122-1088

Mailing address

9803 SW 134TH PL
Miami, FL 33186-2265
Phone (786) 925-3143

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1043900798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9803 SW 134TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862265",
            "telephone_number": "786-925-3143",
            "fax_number": "305-468-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NW 79TH AVE STE 265",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221088",
            "telephone_number": "786-504-4626",
            "fax_number": "305-468-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVENSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "AVALOS PENA",
        "authorized_official_first_name": "ANNEYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-925-3143"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.