Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 12810 | PR |
NPI | 1225056484 |
---|---|
Provider Name | Maricarmen Cruz |
First Address | Guaynabo, PR 00969 |
Second Address | Guaynabo, PR 00969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 12/10/2010 |