Healthcare Provider Details

I. General information

NPI: 1235938838
Provider Name (Legal Business Name): MR. KARL NAVARRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 FAIRGROUND RD
PRINCE FREDERICK MD
20678-4167
US

IV. Provider business mailing address

125 FAIRGROUND RD
PRINCE FREDERICK MD
20678-4167
US

V. Phone/Fax

Practice location:
  • Phone: 410-846-6608
  • Fax:
Mailing address:
  • Phone: 410-846-6608
  • Fax: 410-535-8935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR241652
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: