Healthcare Provider Details

I. General information

NPI: 1164368247
Provider Name (Legal Business Name): NAVAMALAR ROBERTS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W MAIN ST
PENSACOLA FL
32502-5879
US

IV. Provider business mailing address

5700 SPARKLEBERRY LN
PENSACOLA FL
32526-3251
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-7544
  • Fax:
Mailing address:
  • Phone: 850-629-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048650
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: