Provita Physician Group Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVITA PHYSICIAN GROUP CORP

Practice address

4850 W Oakland Park Blvd Ste 102
Lauderdale Lakes, FL 33313-7268

Phone

(786) 419-9192

NPI assigned

Jun 15, 2022

Last updated

Oct 15, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVITA PHYSICIAN GROUP CORPAs reported in NPPES

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

Authorized official

Name

Mr. Osmani Placencia, NPNPI 1760982185

Title

Office Manager

Phone

(305) 878-9072

Specialties & licenses 2

Addresses

Part of

Provita Physician Group Corp

Locations

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.

• Osmani Placencia

  • Nurse Practitioner
  • Hollywood, FL
  • NPI 1760982185
  NPD Authorized official

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1992435622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N UNIVERSITY DR STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 102",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "786-419-9192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3157 N University Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330242258",
            "country_code": "US",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16325 NW 11th St",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281121",
            "country_code": "US",
            "telephone_number": "786-419-9192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVITA PHYSICIAN GROUP CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVITA PHYSICIAN GROUP CORP",
        "enumeration_date": "2022-06-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "PLACENCIA",
        "authorized_official_first_name": "OSMANI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-878-9072",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.