Provider Demographics
NPI:1952434334
Name:NEGRON-MONSERRATE, MAYRA Z (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:Z
Last Name:NEGRON-MONSERRATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194288
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4288
Mailing Address - Country:US
Mailing Address - Phone:787-381-0247
Mailing Address - Fax:787-755-9005
Practice Address - Street 1:32 CALLE MAYAGUEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-4915
Practice Address - Country:US
Practice Address - Phone:787-504-0115
Practice Address - Fax:787-294-9820
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9340208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE-81605Medicare UPIN