Healthcare Provider Details

I. General information

NPI: 1518661677
Provider Name (Legal Business Name): LORENNA GRISELL CRUZ RIVERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 09/25/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL MENONITA GUAYAMA URB LA HACIENDA AVE PEDRO ALBIZU CAMPOS
GUAYAMA PR
00784-0011
US

IV. Provider business mailing address

PO BOX 786
CABO ROJO PR
00623-0786
US

V. Phone/Fax

Practice location:
  • Phone: 787-864-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24520
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: