1235331943 NPI number — MIGUEL A DE VARONA NEGRON M.D.

Table of content: MIGUEL A DE VARONA NEGRON M.D. (NPI 1235331943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235331943 NPI number — MIGUEL A DE VARONA NEGRON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE VARONA NEGRON
Provider First Name:
MIGUEL
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1235331943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BUENA VISTA VILLAGE
Provider Second Line Business Mailing Address:
450 CARR 844 APT 1312
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-746-6003
Provider Business Mailing Address Fax Number:
787-746-6003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 AVE LUIS MUNOZ MARIN HIMA SAN PABLO
Provider Second Line Business Practice Location Address:
SUITE 703
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00726-4980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-363-3311
Provider Business Practice Location Address Fax Number:
787-746-6003
Provider Enumeration Date:
06/04/2007

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: 207R00000X , with the licence number:  17026 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: 17026 , 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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