Healthcare Provider Details

I. General information

NPI: 1114458973
Provider Name (Legal Business Name): SERGIO EMMANUEL BAERGA-NAVARRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1924 CALLE PETUNIA
SAN JUAN PR
00927-6621
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-7878
  • Fax:
Mailing address:
  • Phone: 787-530-9410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME150100
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME150100
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number98671
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: