Provider Demographics
NPI:1083722524
Name:NAVA, GUILLERMO (MD)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:
Last Name:NAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 21ST AVE N
Mailing Address - Street 2:STE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1821
Mailing Address - Country:US
Mailing Address - Phone:407-841-7151
Mailing Address - Fax:407-872-1336
Practice Address - Street 1:1745 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1876
Practice Address - Country:US
Practice Address - Phone:407-841-7151
Practice Address - Fax:407-872-1336
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82868207RC0000X
TN46483207RC0000X
NMMD2004-0063207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM14533821Medicaid
NM14533821Medicaid
FLBA549ZMedicare PIN
NMI03667Medicare UPIN
NM700521019Medicare PIN