Provider Demographics
NPI:1922338664
Name:CRUZ, ROMMEL ALPAPARA (RPT)
Entity Type:Individual
Prefix:MR
First Name:ROMMEL
Middle Name:ALPAPARA
Last Name:CRUZ
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 LA JOYA ST STE D
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2877
Mailing Address - Country:US
Mailing Address - Phone:505-753-6550
Mailing Address - Fax:505-753-1219
Practice Address - Street 1:706 LA JOYA ST STE D
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2877
Practice Address - Country:US
Practice Address - Phone:505-753-6550
Practice Address - Fax:505-753-1219
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist