Healthcare Provider Details

I. General information

NPI: 1538196613
Provider Name (Legal Business Name): PEDRO ENRIQUE NAVARRO REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTH BLVD W SUITE B
LEESBURG FL
34748-5063
US

IV. Provider business mailing address

100 KING ST
EUSTIS FL
32726-4048
US

V. Phone/Fax

Practice location:
  • Phone: 352-315-0050
  • Fax: 352-315-0059
Mailing address:
  • Phone: 352-223-8247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9195891
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9195891
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA13106
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: