Provider Demographics
NPI:1164671970
Name:NEGRONI-BALASQUIDE, XAMAYTA L (MD)
Entity Type:Individual
Prefix:
First Name:XAMAYTA
Middle Name:L
Last Name:NEGRONI-BALASQUIDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 VALLE DE TORRIMAR
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-8707
Mailing Address - Country:US
Mailing Address - Phone:787-222-1048
Mailing Address - Fax:787-474-1370
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:SUITE 910
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-474-8282
Practice Address - Fax:787-474-1370
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR181642080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013694300Medicaid
FLIA351ZOtherMEDICARE PTAN