Provider Demographics
NPI:1073566402
Name:CHINEA CRUZ, BETTY (MD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:
Last Name:CHINEA CRUZ
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 1:400 CALLE UN
Mailing Address - Street 2:CONDOMINIO CASA MAGGIORE APT 518
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-8001
Mailing Address - Country:US
Mailing Address - Phone:787-854-0404
Mailing Address - Fax:787-854-0403
Practice Address - Street 1:J23 CALLE ELLIOT VELEZ
Practice Address - Street 2:URB ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4616
Practice Address - Country:US
Practice Address - Phone:787-854-0404
Practice Address - Fax:787-854-0403
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12868207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0021142Medicare ID - Type Unspecified