Basic Information
Provider Information
NPI: 1689997017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAVARRO
FirstName: ELSY
MiddleName: E
NamePrefix: MRS.
NameSuffix:  
Credential: ANP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1515 N FLAGLER DR STE 101
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334013429
CountryCode: US
TelephoneNumber: 5616591270
FaxNumber:  
Practice Location
Address1: 1250 SOUTHWINDS DR
Address2:  
City: LANTANA
State: FL
PostalCode: 334621459
CountryCode: US
TelephoneNumber: 5618045682
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/12/2010
LastUpdateDate: 12/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XAPRN9380040FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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