Healthcare Provider Details

I. General information

NPI: 1639270887
Provider Name (Legal Business Name): ELSIE CINTRON NADAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 SAN JORGE AVE.
SAN JUAN PR
00912-3239
US

IV. Provider business mailing address

125 CALLE ALELI SAN FRANCISCO DEVELOPMENT
SAN JUAN PR
00927-6306
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1000
  • Fax: 787-268-8702
Mailing address:
  • Phone: 787-758-1209
  • Fax: 787-758-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number5946
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: