Healthcare Provider Details

I. General information

NPI: 1922076488
Provider Name (Legal Business Name): JUAN C. NEGRON - RIVERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL ONCOLOGICO - CUARTO PISO, MEDICINA NUCLEAR CENTRO MEDICO DE PR, BO. MONACILLOS
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

PO BOX 365067 MEDICINA NUCLEAR RCM
SAN JUAN PR
00936-5067
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-3408
  • Fax: 787-622-7852
Mailing address:
  • Phone: 787-758-3408
  • Fax: 787-622-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7038
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number7038
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: