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NPI Code Detail

MEDICARE: DR. JOSE A. CRUZ M.D.

MEDICARE:  DR. JOSE A. CRUZ  M.D.
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
1208D00000XGeneral Practice Physician8556PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18566OTHERPRSTATE LICENSE

General Provider Information

NPI Number : 1194712026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE A. CRUZ M.D.
Provider Business Mailing Address
First Line : COND. EL CORDOBES 11A
Second Line : AVE. SAN PATRICIO
City : GUAYNABO
State : PR
Zip : 00968
Country : US
Telephone Number : 787-870-1529
Fax Number : 787-870-1508
Provider Business Practice Location Address
First Line : 16 CALLE BARCELO
Second Line :
City : TOA ALTA
State : PR
Zip : 00953-2444
Country : US
Telephone Number : 787-870-2270
Fax Number : 787-870-1508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 11/01/2010

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Directions to “ DR. JOSE A. CRUZ M.D.” Practice Location

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