Provider Demographics
NPI:1184025348
Name:CINTRON, EDWIN JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:CINTRON
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:EDWIN
Other - Middle Name:
Other - Last Name:CINTRON
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4175 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5874
Mailing Address - Country:US
Mailing Address - Phone:305-825-0300
Mailing Address - Fax:
Practice Address - Street 1:4175 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5874
Practice Address - Country:US
Practice Address - Phone:305-825-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL784OtherFLORIDA CERTIFICATION BOARD