Provider Demographics
NPI:1699972513
Name:NAVARRETE, NICOLE TERESA (CNM/ARNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:TERESA
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:CNM/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5795
Mailing Address - Country:US
Mailing Address - Phone:954-344-8288
Mailing Address - Fax:954-341-5165
Practice Address - Street 1:8110 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5795
Practice Address - Country:US
Practice Address - Phone:954-344-8288
Practice Address - Fax:954-341-5165
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205877363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA166034607AMedicaid
FL3084540-00Medicaid
FL3084540-00Medicaid