Healthcare Provider Details

I. General information

NPI: 1669762316
Provider Name (Legal Business Name): DANIEL CRUZ GALARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

6501 CAMINOS VERDES APARTAMENTO 310
SAN JUAN PR
00926-0000
US

V. Phone/Fax

Practice location:
  • Phone: 939-246-5793
  • Fax:
Mailing address:
  • Phone: 787-844-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number18706
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: