Provider Demographics
NPI:1962062596
Name:WILLIAMS-NEGRON, LAURA (OPT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:WILLIAMS-NEGRON
Suffix:
Gender:F
Credentials:OPT
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:HC 8 BOX 68920
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-6125
Mailing Address - Country:US
Mailing Address - Phone:787-881-0169
Mailing Address - Fax:787-815-4466
Practice Address - Street 1:CARR 651 KM 2.5
Practice Address - Street 2:BO HATO ARRIBA SECTOR EL JUNCO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-816-7396
Practice Address - Fax:787-815-4433
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR913156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician