Healthcare Provider Details

I. General information

NPI: 1720861982
Provider Name (Legal Business Name): CHRISTIAN MANUEL NEGRON COLLADO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

1793 ASPEN RIVER LN
APEX NC
27502-4495
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone: 819-892-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS66140
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: