Provider Demographics
NPI:1427057033
Name:CRUZ-GARCIA, CESAR P (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:P
Last Name:CRUZ-GARCIA
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:PO BOX 330430
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-0430
Mailing Address - Country:US
Mailing Address - Phone:787-259-3373
Mailing Address - Fax:
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:SUITE 522 SAN LUCAS MEDICAL BUILDING
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4728
Practice Address - Country:US
Practice Address - Phone:787-259-3373
Practice Address - Fax:787-259-3373
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8504207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR220099OtherPREFERRED HEALTH PLAN
PR6550011OtherNMERO DE PROVEEDOR
PR6919OtherNMERO DE PROVEEDOR
PR220099OtherNMERO DE PROVEEDOR
PR6550011OtherHUMANA HEALTH PLAN
PR29703OtherTRIPLE S
PR29703OtherNMERO DE PROVEEDOR
PR6919OtherFIRST MEDICAL
PR29703OtherTRIPLE S
PRE66288Medicare UPIN
PR6550011OtherN�MERO DE PROVEEDOR