Provider Demographics
NPI:1083104384
Name:NEGRON OCASIO, GABRIELA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:MARIA
Last Name:NEGRON OCASIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:M
Other - Last Name:NEGRON OCASIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1049 CALLE 3 SE APT 1109
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3031
Mailing Address - Country:US
Mailing Address - Phone:787-619-0602
Mailing Address - Fax:
Practice Address - Street 1:1156 CALLE 62 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2724
Practice Address - Country:US
Practice Address - Phone:787-582-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR22819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program