Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 16459 | PR |
NPI | 1013084334 |
---|---|
Provider Name | Dr. Nilsa L Cruz |
First Address | Ponce, PR 00715-0220 |
Second Address | Ponce, PR 00716-1115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 30/08/2013 |