MEDICARE: DR. FLOR PATRICIA 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	14448	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21219CR	OTHER	PR	SSS/MEDICARE

General Provider Information

NPI Number	:	1730131624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLOR PATRICIA CRUZ M.D.

Provider Business Mailing Address
First Line	:	CALLE 24A 2V6
Second Line	:	MIRADOR DE BAIROA
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	787-744-6875
Fax Number	:

Provider Business Practice Location Address
First Line	:	2V6 CALLE 24A
Second Line	:	MIRADOR DE BAIROA
City	:	CAGUAS
State	:	PR
Zip	:	00727-1014
Country	:	US
Telephone Number	:	787-744-6875
Fax Number	:

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/09/2007

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