Provider Demographics
NPI:1760821565
Name:CRUZ MANZANO, MARIANA (MD)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:CRUZ MANZANO
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:CONDOMINIO TORRE DEL CARDENAL
Mailing Address - Street 2:675 CALLE S CUEVAS, SPH 16
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-0001
Mailing Address - Country:US
Mailing Address - Phone:787-392-1680
Mailing Address - Fax:787-745-1585
Practice Address - Street 1:PLAZA LOS PRADOS SUITE Z-5
Practice Address - Street 2:200 GRAND BOULEVARD LOS PRADOS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-0001
Practice Address - Country:US
Practice Address - Phone:787-746-3136
Practice Address - Fax:787-745-1585
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01078809A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology