Healthcare Provider Details

I. General information

NPI: 1043343676
Provider Name (Legal Business Name): LUIS H. NEGRON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 NW 7TH ST STE 170
MIAMI FL
33126-3425
US

IV. Provider business mailing address

5040 NW 7TH ST STE 170
MIAMI FL
33126-3425
US

V. Phone/Fax

Practice location:
  • Phone: 305-576-6611
  • Fax: 786-476-2813
Mailing address:
  • Phone: 305-576-6611
  • Fax: 786-476-2813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberACN948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: