Provider Demographics
NPI:1992803589
Name:GODREAU NEGRON, MIGUEL F (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:F
Last Name:GODREAU NEGRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 CALLE COMPOSTELA
Mailing Address - Street 2:COLLEGE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4328
Mailing Address - Country:US
Mailing Address - Phone:787-250-7678
Mailing Address - Fax:787-765-3177
Practice Address - Street 1:HOSPITAL SAN FRANCISCO
Practice Address - Street 2:AVE. DE DIEGO 369 SUITE 404
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-282-8112
Practice Address - Fax:787-765-3177
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4046207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease