Provider Demographics
NPI:1871833996
Name:NEGRON, SHADY PRISCILLA
Entity Type:Individual
Prefix:
First Name:SHADY
Middle Name:PRISCILLA
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 1:15250 SW 134TH PL APT 109
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1187
Mailing Address - Country:US
Mailing Address - Phone:305-497-2956
Mailing Address - Fax:
Practice Address - Street 1:15250 SW 134TH PL APT 109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1187
Practice Address - Country:US
Practice Address - Phone:305-497-2956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist