Provider Demographics
NPI:1053995886
Name:NAVARRO ORTHODONTICS PA
Entity type:Organization
Organization Name:NAVARRO ORTHODONTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-321-0084
Mailing Address - Street 1:2650 NARNIA WAY
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7231
Mailing Address - Country:US
Mailing Address - Phone:813-321-0084
Mailing Address - Fax:813-463-2621
Practice Address - Street 1:2650 NARNIA WAY
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7231
Practice Address - Country:US
Practice Address - Phone:813-321-0084
Practice Address - Fax:813-463-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty