Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14750 NW 77TH CT 301
MIAMI LAKES FL
33016-1507
US

IV. Provider business mailing address

14750 NW 77TH CT 301
MIAMI LAKES FL
33016-1507
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-9463
  • Fax: 305-823-9485
Mailing address:
  • Phone: 305-823-9463
  • Fax: 305-823-9485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JAIME NAVARRO
Title or Position: PRESIDENT
Credential: D.M.D
Phone: 305-823-9463