Provider Demographics
NPI:1760947857
Name:RICARDO NAVARRO D.O., P.A.
Entity Type:Organization
Organization Name:RICARDO NAVARRO D.O., P.A.
Other - Org Name:NAVARRO MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:863-949-6541
Mailing Address - Street 1:1137 DRUID CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4339
Mailing Address - Country:US
Mailing Address - Phone:863-949-6541
Mailing Address - Fax:863-949-6538
Practice Address - Street 1:1137 DRUID CIR
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4339
Practice Address - Country:US
Practice Address - Phone:863-949-6541
Practice Address - Fax:863-949-6538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1346628971OtherNPI
FLOS14384OtherFLORIDA BOARD OF OSTEOPATHIC MEDICINE