Basic Information
| Provider Information | |||||||||
| NPI: | 1245298926 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRUZ | ||||||||
| FirstName: | RICARDO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 374 | ||||||||
| Address2: | SUITE 102 PMB 346 | ||||||||
| City: | CABO ROJO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006230374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879754993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 609 AVE TITO CASTRO | ||||||||
| Address2: | SUITE 102 PMB 346 | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007160200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873197677 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 01/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 11667 | PR | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.