Provider Demographics
NPI:1972566123
Name:JESUS SALVADOR NEGRETTE, M.D., P.A.
Entity Type:Organization
Organization Name:JESUS SALVADOR NEGRETTE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:NEGRETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-554-6644
Mailing Address - Street 1:8410 W FLAGLER ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2092
Mailing Address - Country:US
Mailing Address - Phone:305-554-6644
Mailing Address - Fax:305-554-7244
Practice Address - Street 1:8410 W FLAGLER ST
Practice Address - Street 2:SUITE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2092
Practice Address - Country:US
Practice Address - Phone:305-554-6644
Practice Address - Fax:305-554-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID NUMBER