Provider Demographics
NPI:1790133718
Name:DIAZ CRUZ, LUIS ANGEL (M D)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ANGEL
Last Name:DIAZ CRUZ
Suffix:
Gender:M
Credentials:M D
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 51502
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1502
Mailing Address - Country:US
Mailing Address - Phone:787-710-2532
Mailing Address - Fax:
Practice Address - Street 1:A LA ORDEN SHOPPING CENTER 2ND FL 600
Practice Address - Street 2:2821 PR-167
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00950-1502
Practice Address - Country:US
Practice Address - Phone:787-710-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022351207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology