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General NPI Number Information
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NPI Number | 1881857621
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Entity Type | Individual
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Provider Name | LUZ M DE LA CRUZ CORDERO
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 3 AVE LUIS MUNOZ MARIN
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City | HORMIGUEROS
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State | PR
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Zip | 00660-1750
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Country | US
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Telephone | 787-849-9485
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Fax | 787-849-9485
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Provider Business Mailing Address
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Address Line | AVE. LUIS MUNOZ MARIN #3 PO BOX 788
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City | HORMIGUEROS
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State | PR
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Zip | 00660-0788
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Country | US
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Telephone | 787-849-9485
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Fax | 787-827-8014
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1380
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License Number State | PR
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