Provider Demographics
NPI:1841209947
Name:CRUZADO, EULALIO
Entity Type:Individual
Prefix:
First Name:EULALIO
Middle Name:
Last Name:CRUZADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H13 CALLE 9
Mailing Address - Street 2:URB. VISTA BELLA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-4837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:H13 CALLE 9
Practice Address - Street 2:URB. VISTA BELLA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4837
Practice Address - Country:US
Practice Address - Phone:787-786-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist