MEDICARE: DR. KERWIN XADIEL CRUZ DE LA ROSA 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	208600000X	Surgery Physician	A207506	CA
2	208600000X	Surgery Physician	24469	PR
3	208D00000X	General Practice Physician	24469	PR
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1184171795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERWIN XADIEL CRUZ DE LA ROSA MD

Provider Business Mailing Address
First Line	:	PO BOX 365067
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-5067
Country	:	US
Telephone Number	:	787-758-2525
Fax Number	:

Provider Business Practice Location Address
First Line	:	CENTRO MEDICO DE PUERTO UDH
Second Line	:	BO MONACILLO
City	:	SAN JUAN
State	:	PR
Zip	:	00927
Country	:	US
Telephone Number	:	787-754-0101
Fax Number	:

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	05/21/2026

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