Provider Demographics
NPI:1356463269
Name:NEGRON, TANIA E
Entity Type:Individual
Prefix:MRS
First Name:TANIA
Middle Name:E
Last Name:NEGRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 H 7 ST.
Mailing Address - Street 2:VILLA EL ENCANTO
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-457-1627
Mailing Address - Fax:787-260-0034
Practice Address - Street 1:115 BO. AMUELAS
Practice Address - Street 2:CARR. 592 KM 5.6 CASA DEL VETERANO
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-837-6574
Practice Address - Fax:787-260-0034
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005410183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician