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General NPI Number Information
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NPI Number | 1962719492
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Entity Type | Individual
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Provider Name | ALEJANDRO NAVARRO PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/03/2010
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 1301 PLANTATION ISLAND DR S STE 140
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-3108
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Country | US
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Telephone | 904-461-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 1875 INDIAN RIVER DR
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-7942
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Country | US
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Telephone | 904-718-5836
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106492
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9106492
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License Number State | FL
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