MEDICARE: MR. NESTOR ENRIQUE CRUZ GARCIA

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	103T00000X	Psychologist	8696	PR

General Provider Information

NPI Number	:	1346167483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NESTOR ENRIQUE CRUZ GARCIA

Provider Business Mailing Address
First Line	:	COND LA PROVIDENCIA 1327
Second Line	:	AVE SAN IGNACIO APT 1002
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-463-2577
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND LA PROVIDENCIA 1327
Second Line	:	AVE SAN IGNACIO APT 1002
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-463-2577
Fax Number	:

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

Provider Enumeration Date	:	06/30/2026
Last Update Date	:	06/30/2026

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