Provider Demographics
NPI:1699845602
Name:NEGRON, GLADYS E (MD PSC)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:E
Last Name:NEGRON
Suffix:
Gender:F
Credentials:MD PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CALLE MARLIN AZUL
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3559
Mailing Address - Country:US
Mailing Address - Phone:939-202-1848
Mailing Address - Fax:888-859-5656
Practice Address - Street 1:CARIBBEAN CINEMA SECOND FLOOR
Practice Address - Street 2:#1 OFIC
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:940-382-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065789207VX0000X, 207V00000X, 207V00000X
PR18436207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18436OtherPUERTO RICO STAT MEDICAL LICENSE
PR18436OtherPUERTO RICO STAT MEDICAL LICENSE
CAG47992Medicare UPIN