Provider Demographics
NPI:1730189671
Name:CRUZ, WILLIAM JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAVIER
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:A8 AVE 65 INFANTERIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1834
Mailing Address - Country:US
Mailing Address - Phone:787-740-3010
Mailing Address - Fax:787-740-3009
Practice Address - Street 1:A8 AVE 65 INFANTERIA
Practice Address - Street 2:URB SAN AGUSTIN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00929-0460
Practice Address - Country:US
Practice Address - Phone:787-740-3010
Practice Address - Fax:787-740-3009
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14154174400000X, 2085B0100X, 2085D0003X, 2085N0700X, 2085N0904X, 2085P0229X, 2085R0202X, 2085U0001X
PA141542085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH46747Medicare UPIN
PR0021467Medicare ID - Type Unspecified