Provider Demographics
NPI:1023168366
Name:RODRIGUEZ-CRUZ, GILDA DEL ROSARIO (MD)
Entity type:Individual
Prefix:MRS
First Name:GILDA
Middle Name:DEL ROSARIO
Last Name:RODRIGUEZ-CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 79620
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9620
Mailing Address - Country:US
Mailing Address - Phone:787-791-1221
Mailing Address - Fax:787-791-1221
Practice Address - Street 1:AVE. BORINQUEN ESQINA NIN
Practice Address - Street 2:BO. OBRERO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00916
Practice Address - Country:US
Practice Address - Phone:787-726-7373
Practice Address - Fax:787-726-5898
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC-77596Medicare UPIN