Provider Demographics
NPI:1336576982
Name:CRUZ-INIGO, YOUSEF J (MD)
Entity type:Individual
Prefix:
First Name:YOUSEF
Middle Name:J
Last Name:CRUZ-INIGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 01 BOX 3143
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9407
Mailing Address - Country:US
Mailing Address - Phone:787-342-5349
Mailing Address - Fax:
Practice Address - Street 1:KM 15.5 CARR 159
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2903
Practice Address - Country:US
Practice Address - Phone:787-859-8318
Practice Address - Fax:787-693-0009
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53797207WX0107X
PR13276-I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ201885OtherMEDICARE
AZ243093Medicaid