Organization Active NPI

Prevenza FL, LLC

  • Case Management Agency
  • Miromar Lakes, FL
National Provider Identifier
1407705270
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PREVENZA FL, LLC
Practice address
10771 Vivaldi CT Apt 1402
Miromar Lakes, FL 33913-7686
Phone
(954) 824-9700
NPI assigned
Jan 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Manuel Jimenez, MDNPI 1932737855
Title
Owner
Phone
(954) 824-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

10771 Vivaldi CT Apt 1402
Miromar Lakes, FL 33913-7686

Mailing address

10771 Vivaldi CT Apt 1402
Miromar Lakes, FL 33913-7686
Phone (954) 824-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260318004290 FL Part B Supplier - Clinic/Group Practice 2163906074 Receives reassigned benefits from 1 practitioner
Practice locations: Miromar Lakes, FL

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.

NPI Registry JSON

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

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1407705270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10771 VIVALDI CT APT 1402",
            "city": "MIROMAR LAKES",
            "state": "FL",
            "postal_code": "339137686",
            "telephone_number": "954-824-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10771 VIVALDI CT APT 1402",
            "city": "MIROMAR LAKES",
            "state": "FL",
            "postal_code": "339137686",
            "telephone_number": "954-824-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENZA FL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-824-9700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miromar Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.