Provider Demographics
NPI:1922076488
Name:NEGRON - RIVERA, JUAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:NEGRON - RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:MEDICINA NUCLEAR RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-758-3408
Mailing Address - Fax:787-622-7852
Practice Address - Street 1:HOSPITAL ONCOLOGICO - CUARTO PISO, MEDICINA NUCLEAR
Practice Address - Street 2:CENTRO MEDICO DE PR, BO. MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-758-3408
Practice Address - Fax:787-622-7852
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7038207R00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE04101Medicare UPIN
PR26160DMedicare ID - Type Unspecified