Provider Demographics
NPI:1598325656
Name:CRUZ TIRADO, JULIO ANGEL (MCSW)
Entity Type:Individual
Prefix:MR
First Name:JULIO
Middle Name:ANGEL
Last Name:CRUZ TIRADO
Suffix:
Gender:M
Credentials:MCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CALLE 17
Mailing Address - Street 2:SABANA ENEAS
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-449-7432
Mailing Address - Fax:
Practice Address - Street 1:CALLE FERROCARRIL #1, ESQ. GAMBOA
Practice Address - Street 2:BO. ANCONES
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-903-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical