Provider Demographics
NPI:1750346862
Name:NARVAEZ, LUIS FERNANDO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FERNANDO
Last Name:NARVAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-491-8676
Mailing Address - Fax:954-491-5994
Practice Address - Street 1:2866 E OAKLAND PARK BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1819
Practice Address - Country:US
Practice Address - Phone:954-491-8676
Practice Address - Fax:954-491-5994
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255444500Medicaid
FL44635OtherBCBS
FLE0881WMedicare PIN
FL255444500Medicaid