Individual provider Active NPI

Lourdes Isabel Navarro, PA

  • Medical Physician Assistant
  • Miami Beach, FL
National Provider Identifier
1285641712
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9100740 Issued in FL
Practice address
710 Alton Rd
Miami Beach, FL 33139-5504
Phone
(305) 538-8835
Fax
(305) 994-0054
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9100740 FL Primary

Addresses

Primary practice location

710 Alton Rd
Miami Beach, FL 33139-5504

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
290658900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227001859 FL Order and Referring Only - General PracticePractitioner - General Practice 8921261918

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miami Beach Community Health Center, Inc.Group PAC ID 8123090925, shared by 10 NPIs, 49 clinicians

Practice addresses (Care Compare)

710 Alton Rd
Miami Beach, FL 33139-5504
Phone (305) 538-8835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9100740FLMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1285641712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331395504",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRO",
        "first_name": "LOURDES",
        "middle_name": "ISABEL",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9100740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290658900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.