Provider Demographics
NPI:1760739460
Name:NAVARRO, CARMEN LYDIA
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:LYDIA
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 HIALEAH DR STE 10-12
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5320
Mailing Address - Country:US
Mailing Address - Phone:786-953-6302
Mailing Address - Fax:
Practice Address - Street 1:489 HIALEAH DR STE 10-12
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5320
Practice Address - Country:US
Practice Address - Phone:786-953-6302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI20652355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant