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General NPI Number Information
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NPI Number | 1689923807
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Entity Type | Organization
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Legal Business Name | BELLADONNA MEDICAL WELLNESS INC.
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | CARR# 2 ESQ. BETANCES SHOPPING CAPRI
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-449-8806
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Fax |
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Provider Business Mailing Address
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Address Line | CARR #2 ESQ. BETANCES SHOPPING CAPRI
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVELYN CINTRON
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Credential | M.D.
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Telephone | 787-996-7520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13943
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License Number State | PR
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