Provider Demographics
NPI:1669875753
Name:NAVARRO, JONATHAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 N DREAMY DRAW DR STE 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4668
Mailing Address - Country:US
Mailing Address - Phone:480-882-4545
Mailing Address - Fax:480-882-5814
Practice Address - Street 1:4131 N 24TH ST STE B102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6231
Practice Address - Country:US
Practice Address - Phone:480-882-4545
Practice Address - Fax:602-381-1341
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ5808363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ946988Medicaid