Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 0401415038 | VA |
Y | 1223G0001X | General Practice | 2416 | PR |
Y | 213EG0000X | General Practice | 2416 | PR |
NPI | 1649262437 |
---|---|
Provider Name | Dr. Jose Antonio Cintron Sostre |
First Address | Forest, VA 24551-1030 |
Second Address | Bedford, VA 24523-1966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 30/07/2019 |