Healthcare Provider Details

I. General information

NPI: 1295842698
Provider Name (Legal Business Name): LUIS E JAVIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LUIS ENRIQUE JAVIER NEGRIN M.D.

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 02/01/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 NW 64TH TER STE A
GAINESVILLE FL
32605-4256
US

IV. Provider business mailing address

318 S LINE AVE
INVERNESS FL
34452-4606
US

V. Phone/Fax

Practice location:
  • Phone: 523-315-3103
  • Fax:
Mailing address:
  • Phone: 352-637-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0074651
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME0074651
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME0074651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: