Provider Demographics
NPI:1063026037
Name:NARVAEZ, JARILSA E
Entity Type:Individual
Prefix:
First Name:JARILSA
Middle Name:E
Last Name:NARVAEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-5638
Mailing Address - Country:US
Mailing Address - Phone:321-557-1123
Mailing Address - Fax:
Practice Address - Street 1:3975 SUNSET RD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-5638
Practice Address - Country:US
Practice Address - Phone:321-557-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171R00000X, 172A00000X, 343800000X, 347C00000X, 343900000X
FL372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171R00000XOther Service ProvidersInterpreter
No172A00000XOther Service ProvidersDriver
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty