Healthcare Provider Details

I. General information

NPI: 1366360141
Provider Name (Legal Business Name): ALBERT ANDRES CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 RUTA 5
ISABELA PR
00662
US

IV. Provider business mailing address

137 RUTA 5
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 939-429-0528
  • Fax: 939-429-0528
Mailing address:
  • Phone: 939-429-0528
  • Fax: 939-429-0528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9013
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: