Provider Demographics
NPI:1578569380
Name:NEGRON, DENISE MARIA (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:MARIA
Last Name:NEGRON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1854
Mailing Address - Country:US
Mailing Address - Phone:786-534-4773
Mailing Address - Fax:786-618-9935
Practice Address - Street 1:267 E 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1854
Practice Address - Country:US
Practice Address - Phone:786-534-4773
Practice Address - Fax:786-618-9935
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002209213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057240301Medicaid
FL057240301Medicaid
FL65219Medicare PIN
FL6130680001Medicare NSC