Healthcare Provider Details

I. General information

NPI: 1730189671
Provider Name (Legal Business Name): WILLIAM JAVIER CRUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A8 AVE 65 INFANTERIA URB SAN AGUSTIN
SAN JUAN PR
00929-0460
US

IV. Provider business mailing address

A8 AVE 65 INFANTERIA
SAN JUAN PR
00926-1834
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-3010
  • Fax: 787-740-3009
Mailing address:
  • Phone: 787-740-3010
  • Fax: 787-740-3009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number14154
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number14154
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number14154
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number14154
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number14154
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number14154
License Number StatePR
# 7
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number14154
License Number StatePR
# 8
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number14154
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number14154
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: