Provider Demographics
NPI:1710424320
Name:NAJARRO, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:NAJARRO
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 1:7918 W HILLSBOROUGH AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4608
Mailing Address - Country:US
Mailing Address - Phone:813-374-2444
Mailing Address - Fax:813-644-7040
Practice Address - Street 1:7918 W HILLSBOROUGH AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4608
Practice Address - Country:US
Practice Address - Phone:813-374-2444
Practice Address - Fax:813-644-7040
Is Sole Proprietor?:No
Enumeration Date:2017-01-21
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1051207R00000X, 208D00000X
PR19495208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100357200Medicaid