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NPI Code Detail

MEDICARE: MIREL FELIBERTO NAVARRO GAMBOA CBHCM

MEDICARE:   MIREL FELIBERTO NAVARRO GAMBOA  CBHCM
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
1171M00000XCase Manager/Care CoordinatorCBHCM103395

General Provider Information

NPI Number : 1750029146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIREL FELIBERTO NAVARRO GAMBOA CBHCM
Provider Business Mailing Address
First Line : 7379 NW 173RD DR APT 103
Second Line :
City : HIALEAH
State : FL
Zip : 33015-8429
Country : US
Telephone Number : 786-865-0065
Fax Number :
Provider Business Practice Location Address
First Line : 1905 NW 82ND AVE
Second Line :
City : DORAL
State : FL
Zip : 33126-1011
Country : US
Telephone Number : 786-420-5924
Fax Number : 786-542-5340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 05/25/2022

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Directions to “ MIREL FELIBERTO NAVARRO GAMBOA CBHCM” Practice Location

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