Provider Demographics
NPI:1114190436
Name:NAVARRO HEALTH CENTER PSC
Entity Type:Organization
Organization Name:NAVARRO HEALTH CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVILA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:787-462-8248
Mailing Address - Street 1:CALLE 3 S 5 VILLA MARIA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-4017
Mailing Address - Country:US
Mailing Address - Phone:787-747-2081
Mailing Address - Fax:
Practice Address - Street 1:PARCELA 229 BO. NAVARRO CALLE 1
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-747-2081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15988208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty