Healthcare Provider Details

I. General information

NPI: 1801857123
Provider Name (Legal Business Name): ANA Y CRUZ CABRERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLINICA BORINQUEN SUITE 106 AVE CAMPO RICO
CAROLINA PR
00982
US

IV. Provider business mailing address

COND PORTAL DE SOFIA 111 CELILIO URBINA APTO 3107
GUAYNABO PR
00969-5972
US

V. Phone/Fax

Practice location:
  • Phone: 787-762-9409
  • Fax: 787-701-1134
Mailing address:
  • Phone: 787-268-7271
  • Fax: 787-268-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number15964
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: