Provider Demographics
NPI:1326563644
Name:NEGRO, MARCO (NP-C (FNP); ARNP FL)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:NEGRO
Suffix:
Gender:M
Credentials:NP-C (FNP); ARNP FL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2787 AMELIA RD
Mailing Address - Street 2:
Mailing Address - City:AMELIA ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32034-9114
Mailing Address - Country:US
Mailing Address - Phone:904-428-0106
Mailing Address - Fax:
Practice Address - Street 1:463142 STATE ROAD 200
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-5554
Practice Address - Country:US
Practice Address - Phone:904-225-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9404333363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health