Healthcare Provider Details

I. General information

NPI: 1427057033
Provider Name (Legal Business Name): CESAR P CRUZ-GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 AVE TITO CASTRO SUITE 522 SAN LUCAS MEDICAL BUILDING
PONCE PR
00716-4728
US

IV. Provider business mailing address

PO BOX 330430
PONCE PR
00733-0430
US

V. Phone/Fax

Practice location:
  • Phone: 787-259-3373
  • Fax: 787-259-3373
Mailing address:
  • Phone: 787-259-3373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number8504
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: