MEDICARE: DR. GUILLERMO CRUZ PALOMO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	6974	PR

General Provider Information

NPI Number	:	1033116967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUILLERMO CRUZ PALOMO MD

Provider Business Mailing Address
First Line	:	#78 PINERO ST
Second Line	:	PUEBLO DE RIO PIEDRAS
City	:	SAN JUAN
State	:	PR
Zip	:	00925-3612
Country	:	US
Telephone Number	:	787-765-5715
Fax Number	:	787-765-5715

Provider Business Practice Location Address
First Line	:	#78 PINERO ST
Second Line	:	PUEBLO DE RIO PIEDRAS
City	:	SAN JUAN
State	:	PR
Zip	:	00925-3612
Country	:	US
Telephone Number	:	787-765-5715
Fax Number	:	787-765-5715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/11/2019

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