Provider Demographics
NPI:1598710709
Name:CRUZ RODON, ANA D (OD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:D
Last Name:CRUZ RODON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 CALLE 2
Mailing Address - Street 2:SANTA ISIDRA II
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4164
Mailing Address - Country:US
Mailing Address - Phone:787-860-6060
Mailing Address - Fax:787-860-6061
Practice Address - Street 1:6 JORGE
Practice Address - Street 2:BIRD LEON
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-6060
Practice Address - Fax:787-860-6061
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58019Medicare ID - Type Unspecified
PRT26864Medicare UPIN