Provider Demographics
NPI:1275804262
Name:NEGRON, ASTRID MARI (DO)
Entity Type:Individual
Prefix:MRS
First Name:ASTRID
Middle Name:MARI
Last Name:NEGRON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 943
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0943
Mailing Address - Country:US
Mailing Address - Phone:787-479-1521
Mailing Address - Fax:
Practice Address - Street 1:URB. AGUSTIN STAHL
Practice Address - Street 2:CARR 174 # 79 SUITE 3
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-675-0663
Practice Address - Fax:787-961-8018
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5503103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical