1760821565 NPI number — MARIANA CRUZ MANZANO M.D

Table of content: MARIANA CRUZ MANZANO M.D (NPI 1760821565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760821565 NPI number — MARIANA CRUZ MANZANO M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ MANZANO
Provider First Name:
MARIANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

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:
1760821565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CONDOMINIO TORRE DEL CARDENAL
Provider Second Line Business Mailing Address:
675 CALLE S CUEVAS, SPH 16
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00918-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-392-1680
Provider Business Mailing Address Fax Number:
787-998-3410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 CALLE DE DIEGO TORRE SAN FRANCISCO
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-998-3400
Provider Business Practice Location Address Fax Number:
787-998-3410
Provider Enumeration Date:
06/14/2013

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: 207N00000X , with the licence number:  01078809A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com