Provider Demographics
NPI:1245379031
Name:CRUZ MONTES, LINDA S (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:CRUZ MONTES
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:N14 CALLE AA
Mailing Address - Street 2:CIUDAD UNIVERSITARIA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3130
Mailing Address - Country:US
Mailing Address - Phone:787-292-1480
Mailing Address - Fax:
Practice Address - Street 1:N14 CALLE AA
Practice Address - Street 2:CIUDAD UNIVERSITARIA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3130
Practice Address - Country:US
Practice Address - Phone:787-292-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12342174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20018Medicare ID - Type UnspecifiedFAMILY PHYSICIAN
PRH11713Medicare UPIN