Provider Demographics
NPI:1336921956
Name:CINTRON RUIZ, NOEL SR (MHS)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:CINTRON RUIZ
Suffix:SR
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 CALLE HOARE APT 3C
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-3632
Mailing Address - Country:US
Mailing Address - Phone:787-393-9828
Mailing Address - Fax:
Practice Address - Street 1:611 CALLE HOARE APT 3C
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3632
Practice Address - Country:US
Practice Address - Phone:787-393-9828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4642101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)