Provider Demographics
NPI:1710483573
Name:NEGRON, GIORGIO A (MD)
Entity Type:Individual
Prefix:
First Name:GIORGIO
Middle Name:A
Last Name:NEGRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3985
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:985-985-7075
Practice Address - Street 1:1150 N 35TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-7700
Practice Address - Fax:954-276-0021
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1636662081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119744800Medicaid