Provider Demographics
NPI:1366883548
Name:NAVARRO, JOSE RAFAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAFAEL
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2650 NARNIA WAY STE 101-102
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 STE 101-102
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
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYDN014539122300000X
NY058492-11223P0221X
FLDN231581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry