Healthcare Provider Details

I. General information

NPI: 1972482461
Provider Name (Legal Business Name): ORLANDO OTNIEL NEGRON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 CALLE JAMES BOND
SAN JUAN PR
00924-3432
US

IV. Provider business mailing address

PO BOX 9512
CAROLINA PR
00988-9512
US

V. Phone/Fax

Practice location:
  • Phone: 787-949-1030
  • Fax:
Mailing address:
  • Phone: 787-949-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: