Provider Demographics
NPI:1437699196
Name:NAVARRO, SANDRA L (CNA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 NW SHARPE ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1037
Mailing Address - Country:US
Mailing Address - Phone:954-224-3514
Mailing Address - Fax:
Practice Address - Street 1:615 NW SHARPE ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1037
Practice Address - Country:US
Practice Address - Phone:954-224-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA218611376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide