MEDICARE: DR. MIGUEL A URENA CRUZ 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	207VG0400X	Gynecology Physician	7030	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7030	OTHER	PR	BOARD OF MEDICINE

General Provider Information

NPI Number	:	1780669895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL A URENA CRUZ MD

Provider Business Mailing Address
First Line	:	PO BOX 910
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00613-0910
Country	:	US
Telephone Number	:	787-879-1585
Fax Number	:	787-879-4315

Provider Business Practice Location Address
First Line	:	V1 CALLE 16
Second Line	:	URB VILLA LOS SANTOS
City	:	ARECIBO
State	:	PR
Zip	:	00612-3112
Country	:	US
Telephone Number	:	787-879-1585
Fax Number	:	787-879-4315

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	04/05/2012

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