Provider Demographics
NPI:1376533893
Name:CRUZ-CARRERAS, MARIA TERESA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:CRUZ-CARRERAS
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 1:10 AVE LAGUNA
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6400
Mailing Address - Country:US
Mailing Address - Phone:787-791-5160
Mailing Address - Fax:787-253-3938
Practice Address - Street 1:10 AVE LAGUNA
Practice Address - Street 2:SUITE 207
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6400
Practice Address - Country:US
Practice Address - Phone:787-791-5160
Practice Address - Fax:787-253-3938
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20906Medicare ID - Type Unspecified