Healthcare Provider Details
I. General information
NPI: 1770850216
Provider Name (Legal Business Name): LAUREN JENNIFER NAVAS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/29/2011
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 LONGLEAF PINE PKWY STE 200
ST JOHNS FL
32259-7529
US
IV. Provider business mailing address
4800 BELFORT RD
JACKSONVILLE FL
32256-6004
US
V. Phone/Fax
- Phone: 904-652-0800
- Fax: 904-652-0811
- Phone: 904-398-7205
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: