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General NPI Number Information
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NPI Number | 1588774111
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Entity Type | Individual
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Provider Name | FERNANDO RIVERA CRUZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 1395 CALLE SAN RAFAEL
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City | SAN JUAN
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State | PR
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Zip | 00909-2518
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Country | US
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Telephone | 787-303-5410
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Fax | 939-697-6198
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Provider Business Mailing Address
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Address Line | PO BOX 19416
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City | SAN JUAN
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State | PR
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Zip | 00910-1416
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Country | US
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Telephone | 787-303-5410
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Fax | 939-697-6198
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 13268
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License Number State | PR
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