Healthcare Provider Details

I. General information

NPI: 1346167483
Provider Name (Legal Business Name): MR. NESTOR ENRIQUE CRUZ GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND LA PROVIDENCIA 1327 AVE SAN IGNACIO APT 1002
SAN JUAN PR
00921
US

IV. Provider business mailing address

COND LA PROVIDENCIA 1327 AVE SAN IGNACIO APT 1002
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-463-2577
  • Fax:
Mailing address:
  • Phone: 787-463-2577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8696
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: