Provider Demographics
NPI:1689611907
Name:NEGRON MALDONADO, JOSE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:E
Last Name:NEGRON MALDONADO
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:B1 CALLE SANTA CRUZ
Mailing Address - Street 2:CARIMED PLAZA STE. 506
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6933
Mailing Address - Country:US
Mailing Address - Phone:787-785-3687
Mailing Address - Fax:787-995-0201
Practice Address - Street 1:B1 CALLE SANTA CRUZ
Practice Address - Street 2:CARIMED PLAZA SUITE 506
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6928
Practice Address - Country:US
Practice Address - Phone:787-785-3687
Practice Address - Fax:787-995-0201
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83029Medicare ID - Type UnspecifiedNUMERO PROVEEDOR
PRF96096Medicare UPIN