Provider Demographics
NPI:1538196613
Name:NAVARRO, PEDRO ENRIQUE (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:ENRIQUE
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KING ST
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-4048
Mailing Address - Country:US
Mailing Address - Phone:352-223-8247
Mailing Address - Fax:
Practice Address - Street 1:600 NORTH BLVD W
Practice Address - Street 2:SUITE B
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5063
Practice Address - Country:US
Practice Address - Phone:352-315-0050
Practice Address - Fax:352-315-0059
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9195891163WA2000X, 163WH0200X
FLPTA13106225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant