Healthcare Provider Details

I. General information

NPI: 1932077856
Provider Name (Legal Business Name): CYNTHIA ENID NAZARIO ATO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1419
SAN GERMAN PR
00683-1419
US

IV. Provider business mailing address

HC 1 BOX 5269
JUANA DIAZ PR
00795-9715
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-3333
  • Fax:
Mailing address:
  • Phone: 787-202-5079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number893
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: