Healthcare Provider Details

I. General information

NPI: 1124936158
Provider Name (Legal Business Name): LLERENA CARE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 265
MIAMI FL
33173-3014
US

IV. Provider business mailing address

10300 SW 72ND ST STE 265
MIAMI FL
33173-3014
US

V. Phone/Fax

Practice location:
  • Phone: 305-910-6508
  • Fax:
Mailing address:
  • Phone: 305-910-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GISSELLE LLERENA
Title or Position: OWNER
Credential:
Phone: 305-910-6508