Healthcare Provider Details

I. General information

NPI: 1154474534
Provider Name (Legal Business Name): JOSE LUIS CINTRON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE OSVALDO MOLINA #151 SUITE 102
FAJARDO PR
00738
US

IV. Provider business mailing address

151 AVE OSVALDO MOLINA STE 102
FAJARDO PR
00738-4013
US

V. Phone/Fax

Practice location:
  • Phone: 787-860-0965
  • Fax: 787-860-0965
Mailing address:
  • Phone: 787-860-0965
  • Fax: 787-860-0965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number6957
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: