Provider Demographics
NPI:1548801699
Name:CHEVEREZ NEGRON, JESUS (NP)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:CHEVEREZ NEGRON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 ISLAND GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5099
Mailing Address - Country:US
Mailing Address - Phone:407-587-9331
Mailing Address - Fax:
Practice Address - Street 1:7824 LAKE UNDERHILL RD STE E
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8201
Practice Address - Country:US
Practice Address - Phone:407-392-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty