Provider Demographics
NPI:1730495953
Name:CRUZ, BRENDA ZAHIRA (02/18/1964)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:ZAHIRA
Last Name:CRUZ
Suffix:
Gender:F
Credentials:02/18/1964
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:ZAHIRA
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:02/18/1964
Mailing Address - Street 1:CALLE AMATISTA M 24
Mailing Address - Street 2:URB MADELAINE
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-232-8890
Mailing Address - Fax:
Practice Address - Street 1:CALLE SANTA CRUZ URB. BAYAMON
Practice Address - Street 2:HOSPITAL HIMA SAN PABLO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-232-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRLAMPIKA163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRLAMPIKAOtherNPI