Provider Demographics
NPI:1154474534
Name:CINTRON, JOSE LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LUIS
Last Name:CINTRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:151 AVE OSVALDO MOLINA STE 102
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4013
Mailing Address - Country:US
Mailing Address - Phone:787-860-0965
Mailing Address - Fax:787-860-0965
Practice Address - Street 1:AVE OSVALDO MOLINA #151
Practice Address - Street 2:SUITE 102
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-0965
Practice Address - Fax:787-860-0965
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6957170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
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PR6480064OtherHUMANA
209171OtherPREFERRED UTI
PR2321OtherAMERICANHEALTH
PR332755023OtherPROSAM
PR067587OtherCRUZ AZUL
PR27926OtherTRIPLE S
PR376957OtherUIA
PRPE2054OtherPALICPROVIDER
PR332755023OtherPROSAM