Provider Demographics
NPI:1154939395
Name:NAVARRO, CAROLINA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 NW 200TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2818
Mailing Address - Country:US
Mailing Address - Phone:305-495-3003
Mailing Address - Fax:
Practice Address - Street 1:5190 NW 167TH ST STE 117
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6329
Practice Address - Country:US
Practice Address - Phone:305-517-3047
Practice Address - Fax:305-517-3523
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20231235Z00000X
FLSZ9575390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program