Provider Demographics
NPI:1093186876
Name:CRUZ SOTO, MARGARITA (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:
Last Name:CRUZ SOTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CALLE TAMARINDO
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4655
Mailing Address - Country:US
Mailing Address - Phone:787-610-9656
Mailing Address - Fax:
Practice Address - Street 1:2 AVE. HOSTOS
Practice Address - Street 2:EDIF. MEDICAL EMPORIUM SUITE 406
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12987261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health