Provider Demographics
NPI:1346628971
Name:NAVARRO, RICARDO JAMES (DO)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:JAMES
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 DRUID CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4339
Mailing Address - Country:US
Mailing Address - Phone:863-949-6541
Mailing Address - Fax:863-949-6538
Practice Address - Street 1:1137 DRUID CIR
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853
Practice Address - Country:US
Practice Address - Phone:863-949-6541
Practice Address - Fax:863-949-6538
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine