Healthcare Provider Details

I. General information

NPI: 1528031986
Provider Name (Legal Business Name): GUILLERMO ALBERTO NAVARRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 819 BOX 4488
FPO AE
09645-0045
US

IV. Provider business mailing address

2004 CROWN POINTE BLVD
PENSACOLA FL
32506-8398
US

V. Phone/Fax

Practice location:
  • Phone: 94347273307
  • Fax:
Mailing address:
  • Phone: 302-377-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME135153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: