Provider Demographics
NPI:1376500637
Name:DELACRUZCRUZ, FRANCISCO IV (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:DELACRUZCRUZ
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANCISCO
Other - Middle Name:
Other - Last Name:DE LA CRUZ CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 140910
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-820-1667
Mailing Address - Fax:787-854-3235
Practice Address - Street 1:CARR # 2, CALLE MARGINAL ELLIOTT VELEZ,ESQ.HERNANDEZ
Practice Address - Street 2:URB.ATENAS, CENTRO RADIOLOGICO Y SONOGRAFICO DE MANATI
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-0000
Practice Address - Country:US
Practice Address - Phone:787-854-3131
Practice Address - Fax:787-854-3235
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4836174400000X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4836OtherNEURORADIOLOGY
PR4836OtherRADIOLOGY-NEURORADIOLOGY
PR26501Medicare ID - Type Unspecified
PR4836OtherRADIOLOGY-NEURORADIOLOGY
PR4836OtherNEURORADIOLOGY