MEDICARE: DR. LUIS SAUL CRUZ-GARCIA 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	208D00000X	General Practice Physician	13854	PR

General Provider Information

NPI Number	:	1376528125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS SAUL CRUZ-GARCIA MD

Provider Business Mailing Address
First Line	:	PO BOX 426
Second Line	:
City	:	BOQUERON
State	:	PR
Zip	:	00622-0426
Country	:	US
Telephone Number	:	787-851-9153
Fax Number	:	787-851-9153

Provider Business Practice Location Address
First Line	:	CALLE UNION #15
Second Line	:
City	:	LAJAS
State	:	PR
Zip	:	00667-1978
Country	:	US
Telephone Number	:	787-899-1022
Fax Number	:	787-851-9153

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	03/08/2013

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