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General NPI Number Information
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NPI Number | 1952572067
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Entity Type | Individual
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Provider Name | MICHELLE J GOMEZ CRUZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | SAN JUAN CITY HOSPITAL PMB #498 70344
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City | SAN JUAN
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State | PR
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Zip | 00936-8344
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Country | US
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Telephone | 787-766-2223
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 637
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City | AGUADILLA
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State | PR
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Zip | 00605-0637
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Country | US
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Telephone | 787-975-9458
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 20958
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License Number State | PR
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