Provider Demographics
NPI:1497959308
Name:RODRIGUEZ-CRUZ, DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:RODRIGUEZ-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:PO BOX 1150
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1150
Mailing Address - Country:US
Mailing Address - Phone:787-783-8343
Mailing Address - Fax:787-884-5320
Practice Address - Street 1:GA13 CALLE PALMA SOLA
Practice Address - Street 2:GARDEN HILLS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2920
Practice Address - Country:US
Practice Address - Phone:787-783-8343
Practice Address - Fax:787-884-5320
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6349174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist