Provider Demographics
NPI:1336923788
Name:HEREDIA CRUZ, ORIANA (MD)
Entity Type:Individual
Prefix:
First Name:ORIANA
Middle Name:
Last Name:HEREDIA CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 CALLE DELTA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1702
Mailing Address - Country:US
Mailing Address - Phone:787-214-8200
Mailing Address - Fax:
Practice Address - Street 1:2235 CALLE DELTA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1702
Practice Address - Country:US
Practice Address - Phone:787-214-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine