MEDICARE: HIAM CRUZ-MARCHAND MSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1245602580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIAM CRUZ-MARCHAND MSW

Provider Business Mailing Address
First Line	:	G12 CALLE GLACIER
Second Line	:	URB PARK GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	G12 CALLE GLACIER
Second Line	:	URB PARK GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2113
Country	:	US
Telephone Number	:	787-946-3494
Fax Number	:

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

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	02/22/2016

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