Provider Demographics
NPI:1407899032
Name:GUZMAN CRUZ, ANA I (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:I
Last Name:GUZMAN CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:I
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1311 20TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1885
Mailing Address - Country:US
Mailing Address - Phone:928-221-7496
Mailing Address - Fax:
Practice Address - Street 1:1311 20TH AVE SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1885
Practice Address - Country:US
Practice Address - Phone:928-221-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13589207Q00000X
NMMD2019-0874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ004899Medicaid
AZ004899Medicaid
H67582Medicare UPIN