Provider Demographics
NPI:1073519716
Name:CRUZ-CUEVAS, ELSIE IVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:IVETTE
Last Name:CRUZ-CUEVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 AVE. MUNOZ RIVERA
Mailing Address - Street 2:FIRST FEDERAL BLD SUITE 610
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-772-4669
Mailing Address - Fax:787-281-7615
Practice Address - Street 1:1056 AVE MUNOZ RIVERA
Practice Address - Street 2:FIRST FEDERAL BUILDING #1056 SUITE 610
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5015
Practice Address - Country:US
Practice Address - Phone:787-772-4669
Practice Address - Fax:787-281-7615
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G80856Medicare UPIN
0089801Medicare PIN