Provider Demographics
NPI:1427287465
Name:JACINTO, JOSE MARIA ROBERTO CRUZ (MD)
Entity type:Individual
Prefix:
First Name:JOSE MARIA ROBERTO
Middle Name:CRUZ
Last Name:JACINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 BRYAN DR STE 307
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2158
Mailing Address - Country:US
Mailing Address - Phone:580-931-9400
Mailing Address - Fax:580-931-9403
Practice Address - Street 1:121 DEKALB AVE.
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-6923
Practice Address - Fax:718-250-6080
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2020-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY003410208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery