Provider Demographics
NPI:1083943914
Name:LAMOUTTE-NEGRONI, ANDRE E (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:E
Last Name:LAMOUTTE-NEGRONI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C8 AVE ALEJANDRINO
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4704
Mailing Address - Country:US
Mailing Address - Phone:787-720-4544
Mailing Address - Fax:787-790-1622
Practice Address - Street 1:C8 AVE ALEJANDRINO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4704
Practice Address - Country:US
Practice Address - Phone:787-720-4544
Practice Address - Fax:787-790-1622
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR671-213152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty