Provider Demographics
NPI:1467757617
Name:NAVARRO, REYNALDO (MSW)
Entity Type:Individual
Prefix:
First Name:REYNALDO
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SW ELDERBERRY DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-5411
Mailing Address - Country:US
Mailing Address - Phone:863-634-0930
Mailing Address - Fax:
Practice Address - Street 1:7410 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-1432
Practice Address - Country:US
Practice Address - Phone:772-340-5044
Practice Address - Fax:772-340-5916
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health