Provider Demographics
NPI:1225315575
Name:VICTAN OB. GROUP, CORP
Entity Type:Organization
Organization Name:VICTAN OB. GROUP, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRECIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-860-0965
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:PUERTO REAL
Mailing Address - City:PUERTO REAL
Mailing Address - State:PR
Mailing Address - Zip Code:00740-0046
Mailing Address - Country:US
Mailing Address - Phone:787-860-0965
Mailing Address - Fax:787-860-2169
Practice Address - Street 1:CARIBBEAN MEDICAL CENTER AVE. OSVALDO MOLINA
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:787-860-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty