Provider Demographics
NPI:1578370938
Name:NAVARRO MENDEZ, HAYRO
Entity type:Individual
Prefix:
First Name:HAYRO
Middle Name:
Last Name:NAVARRO MENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 SHADY SUNRISE LOOP
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-2268
Mailing Address - Country:US
Mailing Address - Phone:754-260-7607
Mailing Address - Fax:
Practice Address - Street 1:3316 SHADY SUNRISE LOOP
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33565-2268
Practice Address - Country:US
Practice Address - Phone:754-260-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-390913106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty