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Individual

MR. JUAN DE LA CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
CARR 2 KM. 39.5, BO. ALGARROBO SUITE 110, VEGA BAJA, PR 00693-0000
(787) 858-1580
(787) 807-2930
Mailing address
PO BOX 1554, VEGA BAJA, PR 00694-1554
(787) 454-7690
(787) 807-2930

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3860
PR
208D00000X
General Practice Physician
3860
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4011902
NJ
Enumeration date
08/22/2006
Last updated
05/29/2014
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