Provider Demographics
NPI:1285813972
Name:GARAVITO, NANETTE S (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NANETTE
Middle Name:S
Last Name:GARAVITO
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9767 SW 106TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2848
Mailing Address - Country:US
Mailing Address - Phone:305-412-6312
Mailing Address - Fax:305-412-6312
Practice Address - Street 1:9275 SW 152ND ST
Practice Address - Street 2:101
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1701
Practice Address - Country:US
Practice Address - Phone:305-253-8869
Practice Address - Fax:305-233-9726
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2014-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104391363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant