Healthcare Provider Details

I. General information

NPI: 1184649709
Provider Name (Legal Business Name): DOMINGO R CINTRON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SERGIO CUEVAS BUSTAMANTE #527 URB PARGUE CENTRAL
HATO REY PR
00918
US

IV. Provider business mailing address

PO BOX 363948
SAN JUAN PR
00936-3948
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-7505
  • Fax: 787-758-8705
Mailing address:
  • Phone:
  • Fax: 787-758-8705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3594
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: