Provider Demographics
NPI:1609142140
Name:CRUZ, EDUARDO X (RPH)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:X
Last Name:CRUZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 06 BOX 75227
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-9514
Mailing Address - Country:US
Mailing Address - Phone:787-653-6929
Mailing Address - Fax:787-653-6848
Practice Address - Street 1:200 AVE RAFAEL CORDERO #101
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-6929
Practice Address - Fax:786-536-8489
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist