Healthcare Provider Details

I. General information

NPI: 1811191935
Provider Name (Legal Business Name): MIGUEL ANGEL CINTRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MIGUEL ANGEL CINTRON CARABALLO M.D.

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 NE 54TH TERRACE BOX 1029 CORRECTIONAL COMPLEX COLEMAN MEDIUM
COLEMAN FL
33521-1029
US

IV. Provider business mailing address

909 MARQUEE DR
MINNEOLA FL
34715-6521
US

V. Phone/Fax

Practice location:
  • Phone: 352-689-5103
  • Fax:
Mailing address:
  • Phone: 352-536-2029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number012066
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: