Provider Demographics
NPI:1902901374
Name:NEGRON, ELSIE E (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE
Middle Name:E
Last Name:NEGRON
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 1084
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1084
Mailing Address - Country:US
Mailing Address - Phone:782-892-4950
Mailing Address - Fax:
Practice Address - Street 1:CALLE LUNA # 153 ALHES
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-1084
Practice Address - Country:US
Practice Address - Phone:787-892-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10104208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F18929Medicare UPIN
82585Medicare ID - Type Unspecified