Provider Demographics
NPI:1063628428
Name:NEGRON-VERA, EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:NEGRON-VERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 135 KM 74.4
Mailing Address - Street 2:HC-01 BOX 3926, BO YAUECAS
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:US
Mailing Address - Phone:787-829-6036
Mailing Address - Fax:787-829-6036
Practice Address - Street 1:CARR 135 KM 74.4
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-829-6036
Practice Address - Fax:787-829-6036
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14982208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice