=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013110899
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARNALDO CRUZ IGARTUA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2007
-----------------------------------------------------
Last Update Date | 11/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1513 CALLE PARANA URB. EL PARAISO
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00926-2814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-764-8479
-----------------------------------------------------
Fax | 787-764-8479
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 317 CALLE INTERAMERICANA UNIVERSITY GARDENS
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00927-4011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-764-8479
-----------------------------------------------------
Fax | 787-764-8479
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0802X
-----------------------------------------------------
Taxonomy Name | Addiction Psychiatry Physician
-----------------------------------------------------
License Number | 7654
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------