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General NPI Number Information
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NPI Number | 1831142793
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Entity Type | Organization
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Legal Business Name | JOSE A LOPEZ-CINTRON MD LLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 963 TOWN CENTER DR STE 200
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City | ORANGE CITY
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State | FL
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Zip | 32763-8254
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Country | US
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Telephone | 386-774-9890
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Fax | 386-774-9912
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Provider Business Mailing Address
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Address Line | PO BOX 741044
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City | ORANGE CITY
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State | FL
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Zip | 32774-1044
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Country | US
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Telephone | 386-774-9890
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Fax | 386-774-9912
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | JOSE A LOPEZ-CINTRON
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Credential | MD
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Telephone | 386-774-9890
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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 | ME63977
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License Number State | FL
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