Provider Demographics
NPI:1578720165
Name:NEGRON-MUNOZ, ROSA ENIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ENIS
Last Name:NEGRON-MUNOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 S FLORIDA AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3312
Mailing Address - Country:US
Mailing Address - Phone:863-450-3067
Mailing Address - Fax:863-337-4123
Practice Address - Street 1:6700 S FLORIDA AVE STE 33
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3312
Practice Address - Country:US
Practice Address - Phone:863-450-3067
Practice Address - Fax:863-337-4123
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1112712084F0202X, 2084P0800X, 2084P0804X
PR154482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022279400Medicaid
FL003962200Medicaid