Provider Demographics
NPI:1124106737
Name:CRUZ, OSVALDO L (MD)
Entity type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:L
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:COND. PLAYA AZUL 3
Mailing Address - Street 2:APT. 710
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-0000
Mailing Address - Country:US
Mailing Address - Phone:787-889-6215
Mailing Address - Fax:787-889-3966
Practice Address - Street 1:J6 2 ST. BRISAS DEL MAR
Practice Address - Street 2:SUNNY CITY 102
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-0000
Practice Address - Country:US
Practice Address - Phone:787-889-3966
Practice Address - Fax:787-889-3966
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR05383208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics