Provider Demographics
NPI:1851543904
Name:NAVARRO, MICHELLE OLEA
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:OLEA
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 TAYLOR LANE EXT
Mailing Address - Street 2:#324
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6159
Mailing Address - Country:US
Mailing Address - Phone:239-303-0957
Mailing Address - Fax:
Practice Address - Street 1:1230 TAYLOR LANE EXT
Practice Address - Street 2:#324
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6159
Practice Address - Country:US
Practice Address - Phone:239-303-0957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist