Healthcare Provider Details

I. General information

NPI: 1548801699
Provider Name (Legal Business Name): JESUS CHEVEREZ NEGRON APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3162 CONWAY RD
ORLANDO FL
32812-7331
US

IV. Provider business mailing address

3162 CONWAY RD
ORLANDO FL
32812-7331
US

V. Phone/Fax

Practice location:
  • Phone: 407-392-2273
  • Fax: 833-428-3962
Mailing address:
  • Phone: 407-392-2273
  • Fax: 833-428-3962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11004303
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11004303
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11004303
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: