Provider Demographics
NPI:1457339533
Name:RODRIGUEZ DE LA CRUZ, VERONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:RODRIGUEZ DE LA 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:FLORAL PARK
Mailing Address - Street 2:433 PADRE BERRIOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3427
Mailing Address - Country:US
Mailing Address - Phone:787-758-8383
Mailing Address - Fax:787-753-4517
Practice Address - Street 1:550 SERGIO CUEVAS BUSTAMANTE
Practice Address - Street 2:HOSPITAL DEL MAESTRO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-8383
Practice Address - Fax:787-753-4517
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6203208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0098170OtherTRIPLE S IDENTIFIER
PRD26694Medicare UPIN