Provider Demographics
NPI:1760068555
Name:IRIZARRY CINTRON, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:IRIZARRY CINTRON
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:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0764
Mailing Address - Country:US
Mailing Address - Phone:787-210-5257
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 101 K.M 6.5 INTERIOR
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-210-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22188208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice