All Medicaid billing entities listing PROVENCIO, MAURO (MD/OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Texas | 1 | $92K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | SUN CITY SPORTS MEDICINE AND FAMILY CLINIC, PA | EL PASO, TX | Sports Medicine (Family Medicine) Physician | $92K |