Provita Physician Group Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVITA PHYSICIAN GROUP CORP

Practice address

3157 N University Dr Ste 103
Hollywood, FL 33024-2258

Phone

(954) 322-8985

Fax

(954) 322-8981

NPI assigned

Jun 15, 2022

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

Other identifiers 2

Part of

Provita Physician Group Corp

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• 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": "1787529600000",
    "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": "3157 N UNIVERSITY DR STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        }
    ],
    "practiceLocations": [
        {
            "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": "2026-08-24",
        "certification_date": "2026-08-24",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15388808",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "APRN9243523",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Hollywood, FL
• Providers in Hollywood, 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 Aug 24, 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.