Provider Demographics
NPI:1912405572
Name:CINTRON, MIRANDA ROSE (ATC)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:ROSE
Last Name:CINTRON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 ACADEMY LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2630
Mailing Address - Country:US
Mailing Address - Phone:917-304-1838
Mailing Address - Fax:
Practice Address - Street 1:194 BRATTON LOOP
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-7704
Practice Address - Country:US
Practice Address - Phone:917-304-1838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program