MEDICARE: JUAN R CRUZADO

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	183500000X	Pharmacist	4680	PR

General Provider Information

NPI Number	:	1184574568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN R CRUZADO

Provider Business Mailing Address
First Line	:	CC9 CALLE CASTILLA URB. EDUARDO J SALDANA
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983
Country	:	US
Telephone Number	:	787-462-2765
Fax Number	:

Provider Business Practice Location Address
First Line	:	CC9 CALLE CASTILLA
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983-1966
Country	:	US
Telephone Number	:	787-462-2765
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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