Provider Demographics
NPI:1851696199
Name:RIVERA CRUZ, MARIA CRISTINA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CRISTINA
Last Name:RIVERA CRUZ
Suffix:
Gender:F
Credentials:
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 2963
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-2963
Mailing Address - Country:US
Mailing Address - Phone:787-697-3293
Mailing Address - Fax:
Practice Address - Street 1:VILLA CAROLINA
Practice Address - Street 2:AVE ROBERTO CLEMENTE BLK 27-16
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-276-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1083261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine