1225849508 NPI number — DR. RICARDO ANDRES NEGRON CENTENO MD

Table of content: DR. RICARDO ANDRES NEGRON CENTENO MD (NPI 1225849508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225849508 NPI number — DR. RICARDO ANDRES NEGRON CENTENO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEGRON CENTENO
Provider First Name:
RICARDO
Provider Middle Name:
ANDRES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225849508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COND. LOS NARDOS, CALLE ORTA
Provider Second Line Business Mailing Address:
APT 4F
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-367-1545
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 21 #1785 AVE LAS LOMAS #21
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-782-9999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  002031-P.A. , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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