Provider Demographics
NPI:1134504814
Name:NEGRON-RIVERA, ALWIN (MD)
Entity Type:Individual
Prefix:MR
First Name:ALWIN
Middle Name:
Last Name:NEGRON-RIVERA
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:GPO BOX 364708
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4708
Mailing Address - Country:US
Mailing Address - Phone:787-758-8383
Mailing Address - Fax:787-763-9758
Practice Address - Street 1:CARR 891
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2441
Practice Address - Country:US
Practice Address - Phone:787-859-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine