Provider Demographics
NPI:1396955423
Name:NEGRON, CHARLIE (PHARM D)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:
Last Name:NEGRON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SW 117TH TER APT 2-203
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3488
Mailing Address - Country:US
Mailing Address - Phone:939-630-3677
Mailing Address - Fax:
Practice Address - Street 1:100 SW 117TH TER APT 2-203
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-3488
Practice Address - Country:US
Practice Address - Phone:939-630-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI 16834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist