MEDICARE: RAINIER NAVARRO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6958	NV

General Provider Information

NPI Number	:	1124598032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAINIER NAVARRO

Provider Business Mailing Address
First Line	:	3840 W ANN RD STE 101B
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4404
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 W ANN RD STE 101B
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4404
Country	:	US
Telephone Number	:	702-564-6712
Fax Number	:	702-564-4838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2018
Last Update Date	:	02/10/2026

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Directions to “ RAINIER NAVARRO ” Practice Location

Language	Start Address	Practice Location

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