MEDICARE: RICARDO NAVARRO D.O., 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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1346628971	OTHER	FL	NPI
2	OS14384	OTHER	FL	FLORIDA BOARD OF OSTEOPATHIC MEDICINE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760947857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICARDO NAVARRO D.O., P.A.

Provider Business Mailing Address
First Line	:	1137 DRUID CIR
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4339
Country	:	US
Telephone Number	:	863-949-6541
Fax Number	:	863-949-6538

Provider Business Practice Location Address
First Line	:	1137 DRUID CIR
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4339
Country	:	US
Telephone Number	:	863-949-6541
Fax Number	:	863-949-6538

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICARDO NAVARRO
Credential	:	DO
Telephone Number	:	863-949-6541

Provider Enumeration Date	:	02/04/2019
Last Update Date	:	09/06/2022

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