NPIMap

Organization Active NPI

P. Rene Navarro, MD, PA

  • Clinic/Center
  • Lake Wales, FL
National Provider Identifier
1063609634
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ME28167 Issued in FL
Legal business name
P. RENE NAVARRO, MD, PA
Practice address
1137 Druid Cir
Lake Wales, FL 33853-4339
Phone
(863) 676-0702
Fax
(863) 676-2305
NPI assigned
Sep 27, 2007
Last updated
Nov 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rene Navarro, MD
Title
Owner
Phone
(863) 676-0702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ME28167 FL Primary

Addresses

Primary practice location

1137 Druid Cir
Lake Wales, FL 33853-4339

Mailing address

1137 Druid Cir
Lake Wales, FL 33853-4339
Phone (863) 676-0702

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1063609634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534339",
            "telephone_number": "863-676-0702",
            "fax_number": "863-676-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534339",
            "telephone_number": "863-676-0702",
            "fax_number": "863-676-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P. RENE NAVARRO, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-676-0702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME28167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.