Healthcare Provider Details

I. General information

NPI: 1407211014
Provider Name (Legal Business Name): MARIANNE NEGRON-SASTRE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIANNE NEGRON

II. Dates (important events)

Enumeration Date: 12/24/2015
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E ROBINSON ST SUITE #130
ORLANDO FL
32801-4322
US

IV. Provider business mailing address

PO BOX 4918
ORLANDO FL
32802-4918
US

V. Phone/Fax

Practice location:
  • Phone: 407-581-9180
  • Fax: 865-560-7066
Mailing address:
  • Phone: 407-581-9180
  • Fax: 865-560-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9407633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: