Provider Demographics
NPI:1255374484
Name:CRUZ RUIZ, JOSE JAVIER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JAVIER
Last Name:CRUZ RUIZ
Suffix:
Gender:M
Credentials:PT, DPT
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 3743
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3743
Mailing Address - Country:US
Mailing Address - Phone:787-849-4450
Mailing Address - Fax:787-849-4451
Practice Address - Street 1:349 AVE HOSTOS STE 102
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1511
Practice Address - Country:US
Practice Address - Phone:787-849-4450
Practice Address - Fax:787-849-4451
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR006-1984Medicare ID - Type UnspecifiedPHYSICAL THERAPIST