Provider Demographics
NPI:1457109381
Name:NEGRON-BENEJAM, HECTOR (BSN-27469)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:NEGRON-BENEJAM
Suffix:
Gender:M
Credentials:BSN-27469
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB COSTA BRAVA
Mailing Address - Street 2:CALLE AMBAR 108
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:939-969-3116
Mailing Address - Fax:
Practice Address - Street 1:URB COSTA BRAVA
Practice Address - Street 2:CALLE AMBAR 108
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:939-969-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27469163WH0200X, 163WI0500X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy