Provider Demographics
NPI:1861882904
Name:MUNOZ NEGRON, NYLMARIS
Entity type:Individual
Prefix:
First Name:NYLMARIS
Middle Name:
Last Name:MUNOZ NEGRON
Suffix:
Gender:F
Credentials:
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 4317
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4317
Mailing Address - Country:US
Mailing Address - Phone:787-883-0124
Mailing Address - Fax:787-883-0222
Practice Address - Street 1:CALLE LUIS MUOZ RIVERA #3
Practice Address - Street 2:BO. ESPINOSA
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-0124
Practice Address - Fax:787-883-0222
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21274208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty