Provider Demographics
NPI:1598239329
Name:CRUZ SERRANO, TANYUSHIA M (MD)
Entity Type:Individual
Prefix:
First Name:TANYUSHIA
Middle Name:M
Last Name:CRUZ SERRANO
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:HC 4 BOX 6961
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-9513
Mailing Address - Country:US
Mailing Address - Phone:787-517-1286
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 KM 2 R905
Practice Address - Street 2:BO TEJAS VALERIO
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-9513
Practice Address - Country:US
Practice Address - Phone:787-517-1286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program