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General NPI Number Information
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NPI Number | 1477639490
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Entity Type | Individual
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Provider Name | LUIS R PEREZ CRUZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | ROAD NO. 115 INTERIOR BO PUEBLO
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City | RINCON
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State | PR
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Zip | 00677
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Country | US
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Telephone | 787-823-6150
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 24188
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-9303
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14076
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License Number State | PR
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