Provider Demographics
NPI:1366410300
Name:CINTRON NAZARIO, MAYRA Y (MD)
Entity type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:Y
Last Name:CINTRON NAZARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 8461
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8461
Mailing Address - Country:US
Mailing Address - Phone:787-447-4244
Mailing Address - Fax:787-703-2237
Practice Address - Street 1:URB. VILLA DEL REY ,MUNOZ MARIN AVE.
Practice Address - Street 2:2E1
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-286-6208
Practice Address - Fax:787-703-2237
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13782207Q00000X, 207QA0505X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR061796OtherBLUE CROSS
PR500079SEOtherMMM
PR7390041OtherHUMANA
PRCI20627OtherTRIPLE S
PR7390041OtherHUMANA