Provider Demographics
NPI:1639316052
Name:NEGRON, JOHANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHANN
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
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 1:1034 CALLE CERRO SALIENTE
Mailing Address - Street 2:QUINTAS DE ALTAMIRA
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9107
Mailing Address - Country:US
Mailing Address - Phone:787-318-6966
Mailing Address - Fax:
Practice Address - Street 1:CARR 14 KM 18.3
Practice Address - Street 2:SECTOR TIJERAS
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-318-6966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist