Provider Demographics
NPI:1912581968
Name:NAVARRO, PAULA S (MS)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 BURTON ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8853
Mailing Address - Country:US
Mailing Address - Phone:407-607-0347
Mailing Address - Fax:
Practice Address - Street 1:3125 BRUTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6608
Practice Address - Country:US
Practice Address - Phone:407-514-4470
Practice Address - Fax:407-386-7862
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2813101Y00000X
FLMT4090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty