Healthcare Provider Details

I. General information

NPI: 1427243583
Provider Name (Legal Business Name): CRUZ MARIA MELENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PEDIATRIC UNIVERSITY HOSPITAL MEDICAL CENTER THIRD FLOOR
SAN JUAN PR
00936-0000
US

IV. Provider business mailing address

PEDIATRIC HOSPITAL MEDICAL CENTER FLOOR 3TH
SAN JUAN PR
00936-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3535
  • Fax: 787-764-7004
Mailing address:
  • Phone: 787-777-3535
  • Fax: 787-764-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: