Provider Demographics
NPI:1295842698
Name:JAVIER, LUIS E (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:JAVIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUIS
Other - Middle Name:ENRIQUE
Other - Last Name:JAVIER NEGRIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:318 S LINE AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4606
Mailing Address - Country:US
Mailing Address - Phone:352-637-5678
Mailing Address - Fax:
Practice Address - Street 1:1121 NW 64TH TER STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4256
Practice Address - Country:US
Practice Address - Phone:523-315-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074651207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-2974057OtherTAX ID#
FL253521100Medicaid
FL290010379OtherMEDICARE RAILROAD
FL253521100Medicaid
FL290010379OtherMEDICARE RAILROAD