Healthcare Provider Details

I. General information

NPI: 1558965343
Provider Name (Legal Business Name): FATIMAR CINTRON OMS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CALLE 25 DE JULIO
YAUCO PR
00698-3605
US

IV. Provider business mailing address

PO BOX 483
SABANA GRANDE PR
00637-0483
US

V. Phone/Fax

Practice location:
  • Phone: 787-698-4515
  • Fax:
Mailing address:
  • Phone: 787-698-4515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8672
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14930
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: