MEDICARE: DR. EDGAR COLON NEGRON MD

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	2085R0202X	Diagnostic Radiology Physician	9082	PR

General Provider Information

NPI Number	:	1912006503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDGAR COLON NEGRON MD

Provider Business Mailing Address
First Line	:	P.O.BOX 7891
Second Line	:	PMB 509
City	:	GUAYNABO
State	:	PR
Zip	:	00959-7891
Country	:	US
Telephone Number	:	787-789-1919
Fax Number	:	787-789-1921

Provider Business Practice Location Address
First Line	:	AVE. CASA LINDA NUM. 1 SUITE 101
Second Line	:	ENTRADA AMERICAN MILITARY ACADEMY
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-789-1919
Fax Number	:	787-789-1921

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	06/17/2011

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