Provider Demographics
NPI:1609852383
Name:CRUZ, OLGA I (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:I
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1890 CALLE DIEGO SALAZAR
Mailing Address - Street 2:FAIRVIEW
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7738
Mailing Address - Country:US
Mailing Address - Phone:787-755-7473
Mailing Address - Fax:787-251-4518
Practice Address - Street 1:ADMINISTRACION DE SERVICIOS MEDICOS DE PR
Practice Address - Street 2:BOX 2129
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:777-777-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6473207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE33098Medicare UPIN