Provider Demographics
NPI:1417935396
Name:CINTRON BAERGA, IDAMER (MD)
Entity Type:Individual
Prefix:DR
First Name:IDAMER
Middle Name:
Last Name:CINTRON BAERGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CALLE A
Mailing Address - Street 2:URB SAN BENITO
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-2409
Mailing Address - Country:US
Mailing Address - Phone:787-864-3494
Mailing Address - Fax:787-864-3494
Practice Address - Street 1:207 CALLE MORSE
Practice Address - Street 2:HOSPITAL LAFAYETTE
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2350
Practice Address - Country:US
Practice Address - Phone:787-839-3232
Practice Address - Fax:787-864-3494
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15350204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022369Medicare ID - Type UnspecifiedPROVIDER