Provider Demographics
NPI:1376528125
Name:CRUZ-GARCIA, LUIS SAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:SAUL
Last Name:CRUZ-GARCIA
Suffix:
Gender:M
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 426
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-0426
Mailing Address - Country:US
Mailing Address - Phone:787-851-9153
Mailing Address - Fax:787-851-9153
Practice Address - Street 1:CALLE UNION #15
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-1978
Practice Address - Country:US
Practice Address - Phone:787-899-1022
Practice Address - Fax:787-851-9153
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13854208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-2217Medicare ID - Type Unspecified
PR133381Medicare UPIN