Provider Demographics
NPI:1295042281
Name:CRUZ, DIOSELYN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DIOSELYN
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-04 BOX 7734
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00795
Mailing Address - Country:UM
Mailing Address - Phone:787-487-4796
Mailing Address - Fax:
Practice Address - Street 1:HC-04 BOX 7734
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00795
Practice Address - Country:UM
Practice Address - Phone:787-487-4796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26408363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner