MEDICARE: JAIME NAVARRO D.M.D., P.A.

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)		FL

General Provider Information

NPI Number	:	1649507203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAIME NAVARRO D.M.D., P.A.

Provider Business Mailing Address
First Line	:	14750 NW 77TH CT
Second Line	:	301
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1507
Country	:	US
Telephone Number	:	305-823-9463
Fax Number	:	305-823-9485

Provider Business Practice Location Address
First Line	:	14750 NW 77TH CT
Second Line	:	301
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1507
Country	:	US
Telephone Number	:	305-823-9463
Fax Number	:	305-823-9485

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAIME NAVARRO
Credential	:	D.M.D
Telephone Number	:	305-823-9463

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	11/03/2009

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