Provider Demographics
NPI:1285390005
Name:CINTRON, EILLIM (MED)
Entity type:Individual
Prefix:
First Name:EILLIM
Middle Name:
Last Name:CINTRON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 CHRISTINA DR E
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3433
Mailing Address - Country:US
Mailing Address - Phone:321-331-8918
Mailing Address - Fax:
Practice Address - Street 1:6111 CHRISTINA DR E
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3433
Practice Address - Country:US
Practice Address - Phone:321-331-8918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No174400000XOther Service ProvidersSpecialist