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General NPI Number Information
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NPI Number | 1346995958
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Entity Type | Individual
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Provider Name | RICARDO ANDRES RIVERA-CRUZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 986-990 CLL 42 SE, SAN JUAN, 00921, PUERTO RICO
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-201-8937
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 880
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City | CAMUY
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State | PR
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Zip | 00627-0880
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Country | US
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Telephone | 787-201-8937
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 23412
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License Number State | PR
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