Provider Demographics
NPI:1720789027
Name:NEGRON, JORGE D (BSN)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:D
Last Name:NEGRON
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:MR
Other - First Name:JORGE
Other - Middle Name:D
Other - Last Name:NEGRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN
Mailing Address - Street 1:HC 03 BOX 16083
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENA
Mailing Address - State:PR
Mailing Address - Zip Code:00703
Mailing Address - Country:US
Mailing Address - Phone:787-477-3807
Mailing Address - Fax:
Practice Address - Street 1:URB BRISA DE PALMASOLA CALLE & G 12
Practice Address - Street 2:
Practice Address - City:AGUAS BUENA
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-477-3807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR084568163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice