MEDICARE: DR. CARMEN IRIS SANCHEZ- 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
1	208D00000X	General Practice Physician	4850	PR

General Provider Information

NPI Number	:	1619056165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMEN IRIS SANCHEZ- CRUZ M.D

Provider Business Mailing Address
First Line	:	117 CALLE COLON
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602
Country	:	US
Telephone Number	:	787-868-3398
Fax Number	:

Provider Business Practice Location Address
First Line	:	CPTET
Second Line	:	410 HOSTOS AVE. SUITE 6
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1522
Country	:	US
Telephone Number	:	787-834-2115
Fax Number	:

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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