MEDICARE: DANIEL CAMILO NAVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS68499	FL

General Provider Information

NPI Number	:	1083415590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL CAMILO NAVA

Provider Business Mailing Address
First Line	:	5250 ROYAL CYPRESS CIR # 4-5250
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-5053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 ROYAL CYPRESS CIR # 4-5250
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-5053
Country	:	US
Telephone Number	:	786-389-3530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	03/24/2025

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