Provider Demographics
NPI:1275748618
Name:CRUZ, IRNA MAYSONET (MD)
Entity Type:Individual
Prefix:MRS
First Name:IRNA
Middle Name:MAYSONET
Last Name: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:PO BOX 172
Mailing Address - Street 2:URB. JARDINES DE LAFAYETTE CALLE QO#6
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0172
Mailing Address - Country:US
Mailing Address - Phone:939-645-3074
Mailing Address - Fax:
Practice Address - Street 1:APARTDADO 172
Practice Address - Street 2:URB. JARDINES DE LAFAYETTE CALLE QO#6
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714
Practice Address - Country:US
Practice Address - Phone:939-645-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0294101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)