Provider Demographics
NPI:1184723173
Name:FIELDS, NAVA (OTR L)
Entity type:Individual
Prefix:MRS
First Name:NAVA
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 COCONUT CREEK PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1634
Mailing Address - Country:US
Mailing Address - Phone:954-978-0209
Mailing Address - Fax:954-978-1619
Practice Address - Street 1:3720 COCONUT CREEK PKWY STE B
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1634
Practice Address - Country:US
Practice Address - Phone:954-978-0209
Practice Address - Fax:954-978-0209
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z0302OtherBCBS
5222020001OtherDME CMS
E3245Medicare ID - Type Unspecified