MEDICARE: MRS. SONIA E CRUZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	8234	PR

General Provider Information

NPI Number	:	1124029202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONIA E CRUZ MD

Provider Business Mailing Address
First Line	:	HC 3 BOX 39601
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-9794
Country	:	US
Telephone Number	:	787-450-7674
Fax Number	:	787-868-0345

Provider Business Practice Location Address
First Line	:	AVE ROTARIOS A - 7
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602
Country	:	US
Telephone Number	:	787-450-7674
Fax Number	:	787-868-0345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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