Provider Demographics
NPI:1821728858
Name:CALDERON CINTRON, MILARYS L (SOCIAL WORK CLINIC)
Entity Type:Individual
Prefix:MISS
First Name:MILARYS
Middle Name:L
Last Name:CALDERON CINTRON
Suffix:
Gender:F
Credentials:SOCIAL WORK CLINIC
Other - Prefix:MISS
Other - First Name:MILARYS
Other - Middle Name:L
Other - Last Name:CALDERON CINTRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SOCIAL WORK CLINIC
Mailing Address - Street 1:RR 5 BOX 9254
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9209
Mailing Address - Country:US
Mailing Address - Phone:787-923-2832
Mailing Address - Fax:
Practice Address - Street 1:BARRIO GALATEO CENTRO
Practice Address - Street 2:CARR 804
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0953
Practice Address - Country:US
Practice Address - Phone:787-923-2832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
140551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty