1427057033 NPI number — DR. CESAR P CRUZ-GARCIA M.D.

Table of content: DR. CESAR P CRUZ-GARCIA M.D. (NPI 1427057033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427057033 NPI number — DR. CESAR P CRUZ-GARCIA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ-GARCIA
Provider First Name:
CESAR
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1427057033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 330430
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00733-0430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-259-3373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 AVE TITO CASTRO
Provider Second Line Business Practice Location Address:
SUITE 522 SAN LUCAS MEDICAL BUILDING
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716-4728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-259-3373
Provider Business Practice Location Address Fax Number:
787-259-3373
Provider Enumeration Date:
07/15/2005

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: 207RI0011X , with the licence number:  8504 , 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)

  • Identifier: 220099 . This is a "PREFERRED HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6550011 . This is a "NMERO DE PROVEEDOR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6919 . This is a "NMERO DE PROVEEDOR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 220099 . This is a "NMERO DE PROVEEDOR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6550011 . This is a "HUMANA HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 29703 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 29703 . This is a "NMERO DE PROVEEDOR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6919 . This is a "FIRST MEDICAL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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