Provider Demographics
NPI:1124350293
Name:CINTRON, JORGE I MALAVE (PSY D)
Entity type:Individual
Prefix:DR
First Name:JORGE I
Middle Name:MALAVE
Last Name:CINTRON
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET EUCALIPTO 203
Mailing Address - Street 2:VILLAS DE SAN CRISTOBAL 1
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-9210
Mailing Address - Country:US
Mailing Address - Phone:787-469-7754
Mailing Address - Fax:
Practice Address - Street 1:STREET EUCALIPTO R 21
Practice Address - Street 2:VILLAS DE SAN CRISTOBAL 1
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-9210
Practice Address - Country:US
Practice Address - Phone:787-469-7754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3582OtherPSYCHOLOGIST LICENCES