Provider Demographics
NPI:1083898969
Name:CRUZ-CHACON, ALEXIS MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MANUEL
Last Name:CRUZ-CHACON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 BLVD DE LA MONTANA APT 383
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7115
Mailing Address - Country:US
Mailing Address - Phone:787-758-2000
Mailing Address - Fax:787-771-7593
Practice Address - Street 1:HOSPITAL AUXILIO MUTUO
Practice Address - Street 2:715 PONCE DE LEON PDA 37 1/2
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-2712
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:787-771-7593
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17501207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine