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General NPI Number Information
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NPI Number | 1023768629
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Entity Type | Individual
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Provider Name | BRIAN GUADALUPE CRUZ PHT
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Gender | Male
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | CALLE AUSTRAL 199 URBANIZACION LA MARINA
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City | CAROLINA
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State | PR
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Zip | 00979-4035
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Country | US
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Telephone | 787-223-9775
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE AUSTRAL 199 URBANIZACION LA MARINA
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City | CAROLINA
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State | PR
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Zip | 00979-4035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 010266
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License Number State | PR
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