MEDICARE: DR. ABRAHAM BEAUCHAMP-CRUZ SR. PHD

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	103TC0700X	Clinical Psychologist	244	PR

General Provider Information

NPI Number	:	1881673408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABRAHAM BEAUCHAMP-CRUZ SR. PHD

Provider Business Mailing Address
First Line	:	PO BOX 5438
Second Line	:
City	:	SAN SEBASTIAN
State	:	PR
Zip	:	00685-5438
Country	:	US
Telephone Number	:	787-896-5410
Fax Number	:	787-280-2819

Provider Business Practice Location Address
First Line	:	20 CALLE MUNOZ RIVERA
Second Line	:
City	:	SAN SEBASTIAN
State	:	PR
Zip	:	00685-2249
Country	:	US
Telephone Number	:	787-896-5410
Fax Number	:	787-280-2819

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	12/28/2017

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