Provider Demographics
NPI:1427243583
Name:MELENDEZ, CRUZ MARIA
Entity type:Individual
Prefix:
First Name:CRUZ
Middle Name:MARIA
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PEDIATRIC HOSPITAL MEDICAL CENTER
Mailing Address - Street 2:FLOOR 3TH
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0000
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-764-7004
Practice Address - Street 1:PEDIATRIC UNIVERSITY HOSPITAL MEDICAL CENTER
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-0000
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-764-7004
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health