Provider Demographics
NPI:1508913930
Name:NAVARRO, LUIS E (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:E
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 CALLE DE DIEGO
Mailing Address - Street 2:TORRE SAN FRANCISCO, SUITE 208
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3003
Mailing Address - Country:US
Mailing Address - Phone:787-756-0506
Mailing Address - Fax:787-756-0590
Practice Address - Street 1:369 CALLE DE DIEGO
Practice Address - Street 2:TORRE SAN FRANCISCO, SUITE 208
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-756-0506
Practice Address - Fax:787-756-0590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10525207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82996Medicare ID - Type Unspecified
PRG41389Medicare UPIN