Provider Demographics
NPI:1508332867
Name:CINTRON CARRASQUILLO, IRIS ACSENED
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:ACSENED
Last Name:CINTRON CARRASQUILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VALLE ALTO 1041 CALLE PICACHO
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4136
Mailing Address - Country:US
Mailing Address - Phone:787-651-6654
Mailing Address - Fax:787-651-6654
Practice Address - Street 1:VALLE ALTO 1041 CALLE PICACHO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4136
Practice Address - Country:US
Practice Address - Phone:787-651-6654
Practice Address - Fax:787-651-6654
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR438156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician