Provider Demographics
NPI:1306019898
Name:ELLIOT CINTRON ENTERPRISES PA
Entity type:Organization
Organization Name:ELLIOT CINTRON ENTERPRISES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-384-7115
Mailing Address - Street 1:1875 N CORPORATE LAKES BLVD
Mailing Address - Street 2:SUITE300
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3270
Mailing Address - Country:US
Mailing Address - Phone:954-384-7115
Mailing Address - Fax:954-384-7141
Practice Address - Street 1:1875 N CORPORATE LAKES BLVD
Practice Address - Street 2:SUITE300
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3270
Practice Address - Country:US
Practice Address - Phone:954-384-7115
Practice Address - Fax:954-384-7141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7663261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center