Provider Demographics
NPI:1730294604
Name:CRUZ-LOPEZ, SYDIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:SYDIA
Middle Name:L
Last Name:CRUZ-LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1294
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1294
Mailing Address - Country:US
Mailing Address - Phone:787-805-2418
Mailing Address - Fax:787-841-2565
Practice Address - Street 1:1065 AVE LOS CORAZONES
Practice Address - Street 2:EDIF MEDICO PROFESIONAL OFIC 212
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-7060
Practice Address - Country:US
Practice Address - Phone:787-805-2418
Practice Address - Fax:787-841-2565
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9590207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9590OtherPRACTICE LINCENCE
PR9590OtherPRACTICE LINCENCE