MEDICARE: MRS. NAOMI JESMIL NEGRON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9449097	FL

General Provider Information

NPI Number	:	1194313981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NAOMI JESMIL NEGRON RN

Provider Business Mailing Address
First Line	:	522 CONTRAVEST LN APT 522
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-6338
Country	:	US
Telephone Number	:	801-560-8235
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 CONTRAVEST LN APT 522
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-6338
Country	:	US
Telephone Number	:	801-560-8235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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