Healthcare Provider Details

I. General information

NPI: 1144181157
Provider Name (Legal Business Name): SUSANA FERNANDEZ NAVARRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

IV. Provider business mailing address

4910 NW 79TH AVE APT 101
DORAL FL
33166-5415
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-2500
  • Fax:
Mailing address:
  • Phone: 305-910-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCBHCM.0100636
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: