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General NPI Number Information
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NPI Number | 1225442015
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Entity Type | Organization
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Legal Business Name | CRUZADO RAMOS GINECOLOGY, LLC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | COND ASHFORD PLZ # 1452
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City | SAN JUAN
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State | PR
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Zip | 00911-1102
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Country | US
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Telephone | 787-722-4401
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Fax | 787-722-4405
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Provider Business Mailing Address
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Address Line | O5 CALLE LAS AGUILAS
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City | GUAYNABO
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State | PR
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Zip | 00969-3243
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Country | US
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Telephone | 787-722-4401
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Fax | 787-722-4405
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Authorized Official
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Title or Position | PROPIETARIO
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Name | DR. GUSTAVO CRUZADO
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Credential | M.D.
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Telephone | 787-403-6578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 14905
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License Number State | PR
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