Healthcare Provider Details

I. General information

NPI: 1871402065
Provider Name (Legal Business Name): JOSE FRANCISCO JACINTO-MARTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 KRYSTAL CIR
GOLDSBORO NC
27534-9660
US

IV. Provider business mailing address

203 KRYSTAL CIR
GOLDSBORO NC
27534-9660
US

V. Phone/Fax

Practice location:
  • Phone: 919-222-8598
  • Fax:
Mailing address:
  • Phone: 919-222-8598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number30826906
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: