Provider Demographics
NPI:1265556898
Name:CRUZ, MARCOS JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:JAVIER
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CALLE JUAN C BORBON STE 67-411
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5374
Mailing Address - Country:US
Mailing Address - Phone:615-822-8908
Mailing Address - Fax:615-822-8909
Practice Address - Street 1:6339 CHARLOTTE PIKE # 964
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2926
Practice Address - Country:US
Practice Address - Phone:615-681-2659
Practice Address - Fax:615-822-8909
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA681372084N0400X
CT1.0505112084N0400X
CAA1199962084N0400X
SCMMD.344042084N0400X
MDD00744952084N0400X
PAMD4293592084N0400X
ORMD1558322084N0400X
CO517382084N0400X
FL1146742084N0400X
NY256591-12084N0400X
AZ448522084N0400X
TXS38092084N0400X
NJ25MA086920002084N0400X
PR196132084N0402X
TN434092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I131610OtherMEDICARE
TN1510413Medicaid