Provider Demographics
NPI:1932384526
Name:CRUZ, VICTOR MANUEL (DC)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MANUEL
Last Name:CRUZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BW7 CALLE 113
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-3326
Mailing Address - Country:US
Mailing Address - Phone:787-344-6695
Mailing Address - Fax:
Practice Address - Street 1:BL2 VIA ELENA
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3903
Practice Address - Country:US
Practice Address - Phone:787-344-6695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor