Provider Demographics
NPI:1437344710
Name:CRUZ, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CRUZ
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 1:681 CALLE JAZMIN
Mailing Address - Street 2:HACIENDA FLORIDA
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4541
Mailing Address - Country:US
Mailing Address - Phone:787-267-0887
Mailing Address - Fax:
Practice Address - Street 1:681 CALLE JAZMIN
Practice Address - Street 2:HACIENDA FLORIDA
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4541
Practice Address - Country:US
Practice Address - Phone:787-267-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics