Provider Demographics
NPI:1346204542
Name:NAVIA, JOSE L (ND)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:NAVIA
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CLEVELAND CLINIC BLVD # 23
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3609
Mailing Address - Country:US
Mailing Address - Phone:954-659-5320
Mailing Address - Fax:954-659-5244
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD # 23
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3609
Practice Address - Country:US
Practice Address - Phone:954-659-5320
Practice Address - Fax:954-659-5244
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138999208G00000X
OH35079059N208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2100336Medicaid
OH2100336Medicaid