Provider Demographics
NPI:1760939607
Name:NEGRON, ROSALIE (MS, OTL)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:MS, OTL
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 2017
Mailing Address - Street 2:PMB 546
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-2017
Mailing Address - Country:US
Mailing Address - Phone:787-469-4261
Mailing Address - Fax:
Practice Address - Street 1:C 51 BARRIADA RIVERA
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-469-4261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1093225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist