Provider Demographics
NPI:1699896597
Name:CRUZ, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CRUZ
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:APT. 9676, PLAZA CAROLINA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988
Mailing Address - Country:US
Mailing Address - Phone:787-424-0373
Mailing Address - Fax:787-777-3545
Practice Address - Street 1:FARMACIA CENTRO MEDICO, BO. MONACILLOS
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00922-2129
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:777-787-3545
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2690183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician