Healthcare Provider Details

I. General information

NPI: 1265177364
Provider Name (Legal Business Name): AMANDA CAROLINA CRUZ-LAMBOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. MENDEZ HORMAZABAL 23 CALLE LUIS MUNOZ RIVERA
JUNCOS PR
00777
US

IV. Provider business mailing address

500 GRAND BLVD LOS PRADOS BOX 25101
CAGUAS PR
00727-3401
US

V. Phone/Fax

Practice location:
  • Phone: 939-371-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1046
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: