Provider Demographics
NPI:1225442015
Name:CRUZADO RAMOS GINECOLOGY, LLC
Entity Type:Organization
Organization Name:CRUZADO RAMOS GINECOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIO
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-403-6578
Mailing Address - Street 1:O5 CALLE LAS AGUILAS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3243
Mailing Address - Country:US
Mailing Address - Phone:787-722-4401
Mailing Address - Fax:787-722-4405
Practice Address - Street 1:COND ASHFORD PLZ # 1452
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1102
Practice Address - Country:US
Practice Address - Phone:787-722-4401
Practice Address - Fax:787-722-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14905207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023614Medicare PIN