Provider Demographics
NPI:1578681540
Name:NEGRON, JUAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:NEGRON
Suffix:
Gender:M
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:PO BOX 250634
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0634
Mailing Address - Country:US
Mailing Address - Phone:787-882-7001
Mailing Address - Fax:787-891-4767
Practice Address - Street 1:CARR 110 KM 0.3
Practice Address - Street 2:BO. CEIBA BAJA
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00604
Practice Address - Country:US
Practice Address - Phone:787-882-7001
Practice Address - Fax:787-891-4767
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR00088082Medicare PIN
PRH83771Medicare UPIN