Healthcare Provider Details

I. General information

NPI: 1578362661
Provider Name (Legal Business Name): DR. RAMON CRUZ RIVERA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 CALLE SAN JORGE
SAN JUAN PR
00912-0000
US

IV. Provider business mailing address

PO BOX 404
DORADO PR
00646-0404
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1000
  • Fax:
Mailing address:
  • Phone: 787-648-0810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAMON L. CRUZ RIVERA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-648-0810