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General NPI Number Information
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NPI Number | 1619001252
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Entity Type | Individual
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Provider Name | ERNESTO LUIS CRUZ SR. MD
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Gender | Male
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CARRETBRA #2 AVE HOSTOS 440
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-833-7383
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Fax | 787-833-7383
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Provider Business Mailing Address
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Address Line | BOX 418
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City | SABANA GRANDE
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State | PR
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Zip | 00037
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Country | US
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Telephone | 787-374-3483
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Fax | 787-833-7383
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 6134
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License Number State | PR
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