Healthcare Provider Details

I. General information

NPI: 1780669895
Provider Name (Legal Business Name): MIGUEL A URENA CRUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

V1 CALLE 16 URB VILLA LOS SANTOS
ARECIBO PR
00612-3112
US

IV. Provider business mailing address

PO BOX 910
ARECIBO PR
00613-0910
US

V. Phone/Fax

Practice location:
  • Phone: 787-879-1585
  • Fax: 787-879-4315
Mailing address:
  • Phone: 787-879-1585
  • Fax: 787-879-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number7030
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: