1255374484 NPI number — DR. JOSE JAVIER CRUZ RUIZ PT, DPT

Table of content: DR. JOSE JAVIER CRUZ RUIZ PT, DPT (NPI 1255374484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255374484 NPI number — DR. JOSE JAVIER CRUZ RUIZ PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ RUIZ
Provider First Name:
JOSE
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255374484
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 PARC ESPINAL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00602-3178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-849-4450
Provider Business Mailing Address Fax Number:
787-849-4451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 4 L10 URB COLINAS DEL OESTE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORMIGUEROS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-849-4450
Provider Business Practice Location Address Fax Number:
787-849-4451
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1038 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)