Provider Demographics
NPI:1790827327
Name:NEGRON, CARMEN
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 CALLE PARIS
Mailing Address - Street 2:PMB1367
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3632
Mailing Address - Country:US
Mailing Address - Phone:787-765-8819
Mailing Address - Fax:787-763-6086
Practice Address - Street 1:243 CALLE PARIS
Practice Address - Street 2:PMB1367
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3632
Practice Address - Country:US
Practice Address - Phone:787-753-7356
Practice Address - Fax:787-767-8100
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3316183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician