Organization · Type 2 NPI

Provita Physician Group Corp

Family Medicine Physician · Lauderdale Lakes, FL

NPI number 1992435622 Active

Practice location

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

Call (786) 419-9192 Map

Mailing address

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

Other practice locations

3157 N University Dr Ste 103, Hollywood, FL 33024-2258 · (954) 322-8985
16325 NW 11th St, Pembroke Pines, FL 33028-1121 · (786) 419-9192

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Clinic/Center	261Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

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About NPI 1992435622

Provita Physician Group Corp's National Provider Identifier is 1992435622, issued on Jun 15, 2022. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Lauderdale Lakes, FL. The record was last updated on Oct 15, 2026.