Provider Demographics
NPI:1710470521
Name:CRUZ, OLGA VERONICA (MEDICAL TECHNOLOGIST)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:VERONICA
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MEDICAL TECHNOLOGIST
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7870
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7870
Mailing Address - Country:US
Mailing Address - Phone:787-202-5276
Mailing Address - Fax:
Practice Address - Street 1:E11 URB PORTAL DEL VALLE
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-0000
Practice Address - Country:US
Practice Address - Phone:787-202-5276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7269246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist