Individual provider Active NPI

Rosa Enis Negron-Munoz, MD

  • Child & Adolescent Psychiatry Physician
  • Lakeland, FL
National Provider Identifier
1578720165
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME111271 Issued in FL
Practice address
6700 S Florida Ave Ste 33
Lakeland, FL 33813-3312
Phone
(863) 450-3067
Fax
(863) 337-4123
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X ME111271 FL
Psychiatry Physician 2084P0800X 15448 PR
Psychiatry Physician 2084P0800X ME111271 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME111271 FL Primary

Addresses

Primary practice location

6700 S Florida Ave Ste 33
Lakeland, FL 33813-3312

Mailing address

6700 S Florida Ave Ste 33
Lakeland, FL 33813-3312
Phone (863) 450-3067

Other identifiers 2

IdentifierTypeStateIssuer
022279400MedicaidFL
003962200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15448PRMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yantra Psychiatric Services, Inc. Psychiatry CurrentSince May 1, 2022 Accepting new patients

Locations

6700 S Florida Ave
Ste 33
Lakeland, FL 33813
Phone (863) 330-4097

1014 S Florida Ave
Ste 201
Lakeland, FL 33803

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1578720165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 S FLORIDA AVE STE 33",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133312",
            "telephone_number": "863-450-3067",
            "fax_number": "863-337-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 S FLORIDA AVE STE 33",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133312",
            "telephone_number": "863-450-3067",
            "fax_number": "863-337-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON-MUNOZ",
        "first_name": "ROSA",
        "middle_name": "ENIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "FL",
            "license": "ME111271",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "15448",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME111271",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME111271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022279400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003962200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.