Healthcare Provider Details

I. General information

NPI: 1568456317
Provider Name (Legal Business Name): INGRID MARIE CEDO CINTRON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF LA PALMA 2-D CALLE PERAL #14
MAYAGUEZ PR
00680-4861
US

IV. Provider business mailing address

PO BOX 6492
MAYAGUEZ PR
00681-6492
US

V. Phone/Fax

Practice location:
  • Phone: 787-831-3497
  • Fax: 787-831-3497
Mailing address:
  • Phone: 787-831-3497
  • Fax: 787-831-3497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number533
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number561
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: