Provider Demographics
NPI:1740868538
Name:NAVARRO MEDICAL & AESTHETICS LLC
Entity type:Organization
Organization Name:NAVARRO MEDICAL & AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACKELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-236-0582
Mailing Address - Street 1:HC 2 BOX 120697
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-8369
Mailing Address - Country:US
Mailing Address - Phone:787-236-1553
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 11.5
Practice Address - Street 2:EDIFICIO PLAZA QUINTANA BO. CAP
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-236-1553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care