Provider Demographics
NPI:1508289810
Name:CRUZ, MARIA MARGARITA (1017)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:MARGARITA
Last Name:CRUZ
Suffix:
Gender:F
Credentials:1017
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:MARGARITA
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:1017
Mailing Address - Street 1:CALLE CATALANA # 66
Mailing Address - Street 2:EDIF 1
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:#1 CATALANA STREET
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-717-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10172355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant