MEDICARE: KEYZA SHADARYS CRUZ

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	163W00000X	Registered Nurse	87686	PR

General Provider Information

NPI Number	:	1841125168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEYZA SHADARYS CRUZ

Provider Business Mailing Address
First Line	:	HC 2 BOX 12259
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-9621
Country	:	US
Telephone Number	:	787-469-9520
Fax Number	:

Provider Business Practice Location Address
First Line	:	BO NAVARRO, GURABO SECTOR CIELITO K.M 5.4
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778
Country	:	US
Telephone Number	:	787-469-9520
Fax Number	:	787-469-9520

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

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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Directions to “ KEYZA SHADARYS CRUZ ” Practice Location

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