Provider Demographics
NPI:1912583550
Name:NAVARRETE, STEFANIE NICOLE (DO)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:NICOLE
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 SE TIFFANY AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7567
Mailing Address - Country:US
Mailing Address - Phone:772-398-7936
Mailing Address - Fax:
Practice Address - Street 1:1881 SE TIFFANY AVE STE 102
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7567
Practice Address - Country:US
Practice Address - Phone:772-398-7936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21227207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM