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General NPI Number Information
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NPI Number | 1598325656
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Entity Type | Individual
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Provider Name | JULIO ANGEL CRUZ TIRADO MCSW
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | CALLE FERROCARRIL #1, ESQ. GAMBOA BO. ANCONES
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-903-1852
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Fax |
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Provider Business Mailing Address
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Address Line | 418 CALLE 17 SABANA ENEAS
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-449-7432
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14485
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License Number State | PR
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