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General NPI Number Information
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NPI Number | 1225315575
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Entity Type | Organization
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Legal Business Name | VICTAN OB. GROUP, CORP
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | CARIBBEAN MEDICAL CENTER AVE. OSVALDO MOLINA SUITE 102
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-860-0965
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Fax | 787-860-2169
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Provider Business Mailing Address
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Address Line | PO BOX 46 PUERTO REAL
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City | PUERTO REAL
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State | PR
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Zip | 00740-0046
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Country | US
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Telephone | 787-860-0965
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Fax | 787-860-2169
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Authorized Official
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Title or Position | PRECIDENT
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Name | DR. JOSE LUIS CINTRON
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Credential | M.D.
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Telephone | 787-860-0965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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