Provider Demographics
NPI:1417919903
Name:KENNETH CINTRON CSP
Entity Type:Organization
Organization Name:KENNETH CINTRON CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CINTRON
Authorized Official - Middle Name:D
Authorized Official - Last Name:KENNETH
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-842-7931
Mailing Address - Street 1:2225 PONCE BY PASS SUITE 805
Mailing Address - Street 2:EDIFICO PANA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-1320
Mailing Address - Country:US
Mailing Address - Phone:787-842-7931
Mailing Address - Fax:787-842-7953
Practice Address - Street 1:2225 PONCE BY PASS SUITE 805
Practice Address - Street 2:EDIFICO PANA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-1320
Practice Address - Country:US
Practice Address - Phone:787-842-7931
Practice Address - Fax:787-842-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11797207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG11969Medicare UPIN
PR89048Medicare PIN